0001193125-20-249223 | 10-Q | XBRL Viewer

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Cover Page - shares	6 Months Ended
Cover Page - shares	Jun. 30, 2020	Sep. 17, 2020
Cover [Abstract]
Document Type	10-Q
Entity Registrant Name	ACUTUS MEDICAL, INC.
Amendment Flag	false
Document Period End Date	Jun. 30, 2020
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001522860
Document Quarterly Report	true
Document Transition Report	false
Document Fiscal Year Focus	2020
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Current Reporting Status	No
Entity Interactive Data Current	Yes
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	2210 Faraday Ave.
Entity Address, Address Line Two	Suite 100,
Entity File Number	001-39430
Entity Tax Identification Number	45-1306615
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92008
City Area Code	442
Local Phone Number	232-6080
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	AFIB
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		27,826,408

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 24,295	$ 9,452
Marketable securities	5,037	62,351
Restricted cash	150	150
Accounts receivable	860	263
Inventory	12,266	8,424
Deferred offering costs	2,506
Prepaid expenses and other current assets	1,323	1,816
Total current assets	46,437	82,456
Property and equipment, net	7,584	4,427
Right-of-use asset, net	2,005	2,341
Intangible assets, net	3,890	4,110
Goodwill	12,026	12,026
Other assets	87	95
Total assets	72,029	105,455
Current liabilities:
Accounts payable	9,084	3,882
Accrued liabilities	7,036	10,076
Contingent consideration, short-term	3,500	8,200
Operating lease liabilities, short-term	882	833
Common and preferred stock warrant liability	10,791	8,919
Total current liabilities	31,293	31,910
Operating lease liabilities, long-term	1,594	2,054
Long-term debt	38,558	38,244
Contingent consideration, long-term	4,000	5,700
Total liabilities	75,445	77,908
Commitments and contingencies (Note 11)
Stockholders' deficit
Common stock, $0.001 par value; 260,000,000 shares authorized as of each of June 30, 2020 and December 31, 2019; 775,403 and 695,902 shares issued and outstanding as of June 30, 2020 and December 31, 2019, respectively	1	1
Additional paid-in capital	36,355	33,252
Accumulated deficit	(300,325)	(259,034)
Accumulated other comprehensive loss	(2)	(30)
Total stockholders' deficit	(263,971)	(225,811)
Total liabilities, convertible preferred stock and stockholders' deficit	72,029	105,455
Series A Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	3,059	3,059
Series B Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	40,685	40,685
Series C Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	74,575	74,575
Series D Convertible Preferred Stock [Member]
Convertible preferred stock
Convertible preferred stock	$ 142,236	$ 135,039

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Common Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Common Stock, Shares Authorized	260,000,000	260,000,000
Common Stock, Shares, Issued	775,403	695,902
Common Stock, Shares, Outstanding	775,403	695,902
Series A Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	3,848,696	3,848,696
Preferred Stock, Shares Issued	391,210	391,210
Preferred Stock, Shares Outstanding	391,210	391,210
Preferred Stock, Liquidation Preference, Value	$ 3,245	$ 3,245
Series B Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	30,032,100	30,032,100
Preferred Stock, Shares Issued	3,088,444	3,088,444
Preferred Stock, Shares Outstanding	3,088,444	3,088,444
Preferred Stock, Liquidation Preference, Value	$ 41,294	$ 41,294
Series C Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	48,184,000	48,184,000
Preferred Stock, Shares Issued	4,499,921	4,499,921
Preferred Stock, Shares Outstanding	4,499,921	4,499,921
Preferred Stock, Liquidation Preference, Value	$ 75,000	$ 75,000
Series D Convertible Preferred Stock [Member]
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	90,000,000	90,000,000
Preferred Stock, Shares Issued	8,593,360	8,200,297
Preferred Stock, Shares Outstanding	8,593,360	8,200,297
Preferred Stock, Liquidation Preference, Value	$ 157,348	$ 136,675

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement of Comprehensive Income [Abstract]
Revenue	$ 1,134	$ 734	$ 2,717	$ 1,521
Costs and operating expenses:
Cost of products sold	2,663	2,435	5,857	4,611
Research and development	8,176	5,247	16,149	9,624
Selling, general and administrative	9,125	6,927	19,360	11,020
Change in fair value of contingent consideration	635		(1,584)
Total costs and operating expenses	20,599	14,609	39,782	25,255
Loss from operations	(19,465)	(13,875)	(37,065)	(23,734)
Other income (expense):
Change in fair value of warrant liability and embedded derivative	(2,453)	(1,446)	(1,872)	(605)
Loss on debt extinguishment		(1,398)		(1,398)
Interest income	95	143	370	208
Interest expense	(1,370)	(13,769)	(2,724)	(19,511)
Total other expense, net	(3,728)	(16,470)	(4,226)	(21,306)
Net loss	(23,193)	(30,345)	(41,291)	(45,040)
Other comprehensive income (loss)
Unrealized (loss) gain on marketable securities	(14)	6	(41)	7
Foreign currency translation adjustment	96	2	69	(12)
Comprehensive loss	$ (23,111)	$ (30,337)	$ (41,263)	$ (45,045)
Net loss per common share, basic and diluted	$ (32.24)	$ (45.70)	$ (58.16)	$ (68.21)
Weighted-average shares outstanding, basic and diluted	719,421	663,972	709,961	660,333

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Series A Convertible Preferred Stock [Member]	Series B Convertible Preferred Stock [Member]	Series C Convertible Preferred Stock [Member]	Series D Convertible Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Beginning balances at Dec. 31, 2018		$ 3,059	$ 40,685	$ 74,575
Beginning balances, Shares at Dec. 31, 2018		388,558	3,088,444	4,499,921
Beginning balances at Dec. 31, 2018	$ (131,824)					$ 1	$ 30,150	$ (161,995)	$ 20
Beginning balances, Shares at Dec. 31, 2018						656,654
Unrealized loss on marketable securities	7								7
Foreign currency translation adjustment	(12)								(12)
Issuance of Series A preferred stock for cashless warrant exercise		2,652
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274					$ 38,226
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274, Shares					2,309,959
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes					$ 68,476
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes, Shares					4,108,478
Stock option exercises	57						57
Stock option exercises, Shares						8,469
Stock-based compensation	1,362						1,362
Stock-based compensation, Shares						6,837
Net loss	(45,040)							(45,040)
Ending balances at Jun. 30, 2019		$ 3,059	$ 40,685	$ 74,575	$ 106,702
Ending balances, shares at Jun. 30, 2019		391,210	3,088,444	4,499,921	6,418,437
Ending balances at Jun. 30, 2019	(175,450)					$ 1	31,569	(207,035)	15
Ending balances, shares at Jun. 30, 2019						671,960
Beginning balances at Mar. 31, 2019		$ 3,059	$ 40,685	$ 74,575
Beginning balances, Shares at Mar. 31, 2019		391,210	3,088,444	4,499,921
Beginning balances at Mar. 31, 2019	(145,973)					$ 1	30,709	(176,690)	7
Beginning balances, Shares at Mar. 31, 2019						656,654
Unrealized loss on marketable securities	6								6
Foreign currency translation adjustment	2								2
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274					$ 38,226
Issuance of Series D convertible preferred stock for cash, net of issuance costs of $274, Shares					2,309,959
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes					$ 68,476
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes, Shares					4,108,478
Stock option exercises	57						57
Stock option exercises, Shares						8,469
Stock-based compensation	803						803
Stock-based compensation, Shares						6,837
Net loss	(30,345)							(30,345)
Ending balances at Jun. 30, 2019		$ 3,059	$ 40,685	$ 74,575	$ 106,702
Ending balances, shares at Jun. 30, 2019		391,210	3,088,444	4,499,921	6,418,437
Ending balances at Jun. 30, 2019	(175,450)					$ 1	31,569	(207,035)	15
Ending balances, shares at Jun. 30, 2019						671,960
Beginning balances at Dec. 31, 2019		$ 3,059	$ 40,685	$ 74,575	$ 135,039
Beginning balances, Shares at Dec. 31, 2019		391,210	3,088,444	4,499,921	8,200,297
Beginning balances at Dec. 31, 2019	(225,811)					$ 1	33,252	(259,034)	(30)
Beginning balances, Shares at Dec. 31, 2019						695,902
Unrealized loss on marketable securities	(41)								(41)
Foreign currency translation adjustment	69								69
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase					$ 5,000
Issuance of Series D convertible preferred stock for the Biotronik Asset Purchase, Shares					273,070
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition					$ 2,197
Issuance of Series D convertible preferred stock for the contingent consideration related to the Rhythm Xience Acquisition, Shares					119,993
Stock option exercises	205						205
Stock option exercises, Shares						64,562
Stock-based compensation	2,898						2,898
Stock-based compensation, Shares						14,939
Net loss	(41,291)							(41,291)
Ending balances at Jun. 30, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Ending balances, shares at Jun. 30, 2020		391,210	3,088,444	4,499,921	8,593,360
Ending balances at Jun. 30, 2020	(263,971)					$ 1	36,355	(300,325)	(2)
Ending balances, shares at Jun. 30, 2020						775,403
Beginning balances at Mar. 31, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Beginning balances, Shares at Mar. 31, 2020		391,210	3,088,444	4,499,921	8,593,360
Beginning balances at Mar. 31, 2020	(242,222)					$ 1	34,993	(277,132)	(84)
Beginning balances, Shares at Mar. 31, 2020						710,841
Unrealized loss on marketable securities	(14)								(14)
Foreign currency translation adjustment	96								96
Stock option exercises	205						205
Stock option exercises, Shares						64,562
Stock-based compensation	1,157						1,157
Net loss	(23,193)							(23,193)
Ending balances at Jun. 30, 2020		$ 3,059	$ 40,685	$ 74,575	$ 142,236
Ending balances, shares at Jun. 30, 2020		391,210	3,088,444	4,499,921	8,593,360
Ending balances at Jun. 30, 2020	$ (263,971)					$ 1	$ 36,355	$ (300,325)	$ (2)
Ending balances, shares at Jun. 30, 2020						775,403

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019
Payments of Financing Costs [Abstract]
Payments of Stock Issuance Costs	$ 274	$ 274

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Cash flows from operating activities
Net loss	$ (41,291)	$ (45,040)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	978	1,142
Amortization of intangible assets	220	0
Stock-based compensation expense	2,898	1,362
Accretion of discounts/(amortization of premiums) on marketable securities, net	5	(19)
Amortization of debt issuance costs	314	17,309
Amortization of right-of-use assets	336	312
Loss on debt extinguishment		1,398
Change in fair value of warrant liability and embedded derivative	1,872	605
Change in fair value of contingent consideration	(1,584)
Changes in operating assets and liabilities, net of effect from business combination:
Accounts receivable	(597)	(280)
Inventory	(3,616)	(1,961)
Prepaid expenses and other current assets	666	(43)
Other assets	8	(12)
Accounts payable	5,286	1,682
Accrued liabilities	155	1,810
Operating lease liabilities	(411)	(349)
Net cash used in operating activities	(34,761)	(22,084)
Cash flows from investing activities
Purchases of available-for-sale marketable securities		(22,208)
Sales of available-for-sale marketable securities	17,095
Maturities of available-for-sale marketable securities	40,000	8,100
Purchases of property and equipment	(4,445)	(316)
Cash paid, net of cash acquired for the Rhythm Xience Acquisition		(3,000)
Net cash provided by (used in) investing activities	52,650	(17,424)
Cash flows from financing activities
Proceeds from issuance of debt and warrants		77,000
Repayment of debt		(15,000)
Payment of issuance and extinguishment costs related to debt		(2,332)
Payment of contingent consideration	(2,619)
Proceeds from issuance of convertible preferred stock, net of issuance costs		38,226
Payment of deferred offering costs	(701)
Proceeds from stock options exercises	205	57
Net cash (used in) provided by financing activities	(3,115)	97,951
Effect of exchange rate changes on cash, cash equivalents and restricted cash	69	(12)
Net change in cash, cash equivalents and restricted cash	14,843	58,431
Cash, cash equivalents and restricted cash, at the beginning of the period	9,602	9,775
Cash, cash equivalents and restricted cash, at the end of the period	24,445	68,206
Supplemental disclosure of cash flow information:
Cash paid for income taxes
Cash paid for interest	2,376	1,168
Supplemental disclosure of noncash investing and financing activities:
Issuance of Series D convertible preferred stock for 2018 Convertible Notes and 2019 Convertible Notes		68,476
Issuance of Series D convertible preferred stock for Biotronik asset purchase	5,000
Issuance of Series D convertible preferred stock for Rhythm Xience Acquisition	2,197
Change in unrealized (gain) loss on marketable securities	41	(7)
Warrants issued in conjunction with OrbiMed debt		872
Right-of-use assets exchanged for operating lease liabilities		2,978
Unpaid purchases of property and equipment	55	$ 77
Unpaid deferred offering costs	$ 1,805

Organization and Description of Business	6 Months Ended
Organization and Description of Business	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Note 1—Organization and Description of Business Acutus Medical, Inc. (the “Company”) is an arrhythmia management company focused on improving the way cardiac arrhythmias are diagnosed and treated. The Company designs, manufactures and markets a range of tools for catheter-based ablation procedures to treat various arrhythmias. The Company’s product portfolio includes novel access sheaths, transseptal crossing tools, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Reverse Stock Split The Company’s board of directors approved a reverse split of shares of the Company’s common stock and convertible preferred stock on a 9.724-for-one basis (the “Reverse Stock Split”), which was effected on July 28, 2020. The par value and the number of authorized shares of the convertible preferred stock and common stock were not adjusted in connection with the Reverse Stock Split. All references to common stock, convertible preferred stock, warrants to purchase common stock, warrants to purchase convertible preferred stock, options to purchase common stock, restricted stock units, restricted stock awards, share data, per share data and related information contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the effect of the Reverse Stock Split for all periods presented. No fractional shares of the Company’s common stock were issued in connection with the Reverse Stock Split. Any fractional share resulting from the Reverse Stock Split was rounded down to the nearest whole share, and any stockholder entitled to a fractional share as a result of the Reverse Stock Split will receive a cash payment in lieu of receiving fractional shares. See Note 19 – Subsequent Events for further information. Initial Public Offering On August 10, 2020, the Company issued 10,147,058 shares of common stock in an initial public offering (“IPO ”), which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price to the pu blic for each share was $18.00. On August 10, 2020, in connection with the closing of the IPO, 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock and the warrants to purchase 446,990 shares of Series D convertible preferred stock were automatically converted to an equal number of warrants to purchase common stock at an exercise price of $16.67 per share. As a result of the IPO, the underwriters’ exercise of their option, and the conversions of the Series A, B, C and D convertible preferred stock, the Company’s total number of outstanding shares increased by 26,719,993 immediately following the closing of the IPO. See Note 19 – Subsequent Events for further information. Going Concern, Liquidity and Capital Resources The Company has limited revenue, has incurred operating losses since inception and expects to continue to incur significant operating losses for at least the next several years and may never become profitable. As of June 30, 2020 and December 31, 2019, the Company had an accumulated deficit of $300.3 million and $259.0 million, respectively, and working capital of $15.1 million and $50.5 million, respectively. The Company has historically funded its operations primarily through the sale of debt and equity securities, as well as other indebtedness. With the closing of the Company’s IPO, the Company’s current cash and cash equivalents are sufficient to fund operations for at least the next 12 months. However, the Company may need to raise additional funds through one or more of the following: issuance of additional debt, equity or both. Until such time, if ever, the Company can generate revenue sufficient to achieve profitability, the Company expects to finance its operations through equity or debt financings, which may not be available to the Company on the timing needed or on terms that the Company deems to be favorable. To the extent that the Company raises additional capital through the sale of equity or convertible debt securities, the ownership interest of its stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of common stockholders. Debt financing and preferred equity financing, if available, may involve agreements that include covenants limiting or restricting the Company’s ability to take specific actions, such as incurring additional debt, making acquisitions or capital expenditures or declaring dividends. If the Company is unable to maintain sufficient financial resources, its business, financial condition and results of operations will be materially and adversely affected. The Company may be required to delay, limit, reduce or terminate its product discovery and development activities or future commercialization efforts. There can be no assurance that the Company will be able to obtain the needed financing on acceptable terms or at all. Beginning in early March 2020, the COVID-19 pandemic and the measures imposed to contain this pandemic disrupted the Company’s business. The effects of the pandemic began to decrease in late April 2020 as electrophysiology labs began reopening and procedure volumes began increasing as compared to COVID-19 related low points in March 2020. The Company could experience similar, or even more sustained, access restrictions or decreases in procedural activities as hospitals continue to deal with the COVID-19 pandemic. If cases of COVID-19 increase and hospitals again prioritize those patients, additional restrictions may be implemented which would adversely impact our business and financial results.

Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2020

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Note 2—Summary of Significant Accounting Policies

Basis of Presentation

The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form

10-Q

and Article 10 of Regulation

S-X.

Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.

Principles of Consolidation

The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiary Acutus Medical NV (“Acutus NV”), which was incorporated under the laws of Belgium in August 2013. All intercompany balances and transactions have been eliminated in consolidation.

Use of Estimates and Assumptions

The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, expenses and disclosures of contingent assets and liabilities. The most significant estimates and assumptions in the Company’s condensed consolidated financial statements include, but are not limited to, revenue recognition, useful lives of intangible assets, assessment of impairment of goodwill, provisions for income taxes, measurement of operating lease liabilities, and the fair value of common stock, stock options, warrants, intangible assets, contingent consideration and goodwill. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of expenses that are not readily apparent from other sources. Actual results could differ from those estimates.

Segments

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business in one operating segment.

Cash and Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of June 30, 2020 and December 31, 2019, exceeded federally insured limits.

Restricted cash serves as collateral for the Company’s corporate credit card program. The following table reconciles cash and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands):


	June 30, 2020		December 31, 2019
	(unaudited)
Cash and cash equivalents	$	24,295	$	9,452
Restricted cash		150		150

Total cash, cash equivalents and restricted cash	$	24,445	$	9,602

Marketable Securities

The Company considers its debt securities to be

available-for-sale

securities.

Available-for-sale

securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term

available-for-sale

securities and are reported as a component of current assets.

Securities that are classified as

available-for-sale

are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders’ deficit until their disposition or maturity. See “Fair Value Measurements” below. The Company reviews all

available-for-sale

securities at each period end to determine if they remain

available-for-sale

based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method.

Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive loss for the

six-month

periods ended June 30, 2020 and 2019.

Deferred Offering Costs

Deferred offering costs consist of legal and accounting fees incurred through the balance sheet date that are directly related to the Company’s IPO and will be reflected as issuance costs upon the completion of the offering.

Concentrations of Credit Risk and

Off-Balance

Sheet Risk

Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash are maintained in accounts with financial institutions, which, at times may exceed the Federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant. The Company’s marketable securities portfolio consists primarily of investments in money market funds, commercial paper and short-term high credit quality corporate debt securities.

Revenue from Contracts with Customers

The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606,

Revenue from Contracts with Customers

(“ASC 606”). The core principle of the revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle:

•

Step 1: Identify the contract with the customer.

•

Step 2: Identify the performance obligations in the contract.

•

Step 3: Determine the transaction price.

•

Step 4: Allocate the transaction price to the performance obligations in the contract.

•

Step 5: Recognize revenue when, or as, the company satisfies a performance obligation.

The Company

usually

places its medical diagnostic equipment, AcQMap System, at customer sites under loan agreements and generates revenue from disposable products used with the AcQMap System. Disposable products include AcQMap Catheters and AcQGuide Steerable Sheaths. The Company provides the disposable products in exchange for consideration, which occurs when a customer submits a purchase order and the Company provides disposables at the agreed upon prices in the invoice. Generally, customers purchase disposable products using separate purchase orders after the equipment has been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company also sells the AcQMap System to customers along with software updates on a

when-and-if-available

basis and equipment service. The Company has elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. The following table sets forth the Company’s revenue for disposables and systems/service for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Disposables	$	1,122	$	730	$	2,179	$	1,512
Systems		—		—	$	520		—
Service/Other		12		4		18		9

Total	$	1,134	$	734	$	2,717	$	1,521

The Company’s contracts only include fixed consideration. There are no discounts, rebates, returns or other forms of variable consideration. Customers are generally required to pay within 30 to 60 days.

The delivery of disposable products are performance obligations satisfied at a point in time. The disposable products are shipped Free on Board (“FOB”) shipping point or FOB destination. For disposable products that are shipped FOB shipping point, the customer has the significant risks and rewards of ownership and legal title to the assets when the disposable products leave the Company’s shipping facilities, thus the customer obtains control and revenue is recognized at that point in time. Revenue is recognized on delivery for disposable products shipped via FOB destination.

The installation and delivery of the AcQMap system is satisfied at a point in time when the installation is complete, which is when the customer can benefit and has control of the system. The Company’s software updates and equipment service performance obligations are satisfied evenly over time as the customer simultaneously receives and consumes the benefits of the Company’s performance for these services throughout the service period.

The Company allocates the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company determines SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which includes, but is not limited to, transactions where the specific performance obligations are sold separately, list prices, and offers to customers.

The Company’s contracts with customers generally have an expected duration of one year or less, and therefore the Company has elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts are recorded as selling, general and administrative expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of June 30, 2020 and December 31, 2019.

In May 2020, the Company entered into

bi-lateral

distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the

“Bi-Lateral

Distribution Agreements”). Pursuant to the

Bi-Lateral

Distribution Agreements, the Company obtained a

non-

exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption, or IDE, clinical trial is required for these products to obtain regulatory approval in the United States, or a clinical trial is required for these products to obtain regulatory approval in China, the Company will obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covers the cost of the IDE or other clinical trial and the Company conducts such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a coexclusive right to distribute these products in Hong Kong. Each party will pay to the other party specified transfer prices on the sale of the other party’s products and, accordingly, will earn a distribution margin on the sale of the other party’s products.

The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
United States	$	559	$	221	$	1,328	$	456
Europe		575		513		1,389		1,065

Total Revenue	$	1,134	$	734	$	2,717	$	1,521

Inventory

Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost

(first-in,

first-out

basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory based on management’s review of inventories on hand, compared to estimated future usage and sales, shelf-life and assumptions about the likelihood of obsolescence of $0.1 million and $0.1 million, for the three months ended June 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million, for the six months ended June 30, 2020 and 2019, respectively.

Accounts Receivable

Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of June 30, 2020 and December 31, 2019.

Property and Equipment, Net

Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.

Intangible Assets

Intangible assets consist of acquired developed technology, acquired

in-process

technology, trademarks and trade names and a customer-related intangible which were acquired as part of the acquisition of Rhythm Xience, Inc. (“Rhythm Xience”) in June 2019. The Company determines the appropriate useful life of its finite-lived intangible assets by performing an analysis of expected cash flows of the acquired assets. Finite-lived intangible assets are amortized over their estimated useful lives using the straight-line method, which approximates the pattern in which the economic benefits are consumed. Acquired

in-process

technology was classified as an indefinite-lived intangible asset, until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the

in-process

technology was classified as a finite-lived intangible and amortization for

in-process

technology began. Indefinite-lived intangible assets are tested for impairment at least annually and are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Indefinite

lived intangible assets are impaired if their estimated fair values are less than their carrying value.

Goodwill

Goodwill represents the excess of the purchase price of an entity over the estimated fair value of the assets acquired and liabilities assumed, and it is presented as goodwill in the accompanying condensed consolidated balance sheets. Under ASC 350,

Intangibles

– Goodwill and Other

(“ASC 350”), goodwill is not amortized but is subject to periodic impairment testing. ASC 350 requires that an entity assign its goodwill to reporting units and test each reporting unit’s goodwill for impairment at least on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. In the evaluation of goodwill for impairment, which is performed annually during the fourth quarter, the Company first assesses qualitative factors to determine whether the existence of events or circumstances led to a determination that it was more likely than not that the fair value of a reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, it is determined that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, the Company is required to perform the quantitative goodwill impairment test. The Company has one reporting unit. For the six months ended June 30, 2020, the qualitative testing did not indicate any impairment for the carrying amount of goodwill.

Impairment of Long-Lived Assets

The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and six months ended June 30, 2020 and 2019, the Company determined that there was no impairment of property and equipment or intangible assets.

Foreign Currency Translation and Transactions

The assets, liabilities and results of operations of Acutus NV are measured using their functional currency, the Euro, which is the currency of the primary foreign economic environment in which this subsidiary operates. Upon consolidating this entity with the Company, its assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and its revenues and expenses are translated at the weighted-average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating this entity’s financial statements are reported in accumulated other comprehensive loss in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive loss.

Leases

Effective January 1, 2019, the Company accounts for its leases under ASC 842,

Leases

(“ASC 842”). Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheet as both a

right-of-use

asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the

right-of-use

asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the

right-of-use

asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the

right-of-use

asset and lease liability, the Company elects to combine lease and

non-lease

components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election.

Cost of Products Sold

Cost of products sold includes raw materials, direct labor, manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.

Research and Development

The Company is actively engaged in new product research and development efforts. Research and development expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. Research and development expenses also include payments for the asset acquisition from Biotronik and VascoMed GmbH (collectively, the “Biotronik Parties”) for certain licenses of patents, technology,

know-how

rights and equipment (the “Biotronik Asset Acquisition”).

Research and development expenses relating to possible future products are expensed as incurred. The Company also accrues and expenses costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites are expensed as incurred. Clinical trial site costs related to patient enrollment are accrued as patients are entered into the trials.

Selling, General and Administrative

Selling, general and administrative (“SG&A”) expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in sales, executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, marketing costs and insurance costs. The Company expenses all SG&A costs as incurred.

Fair Value Measurements

Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy has been used in determining the inputs used in measuring fair value:

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.

Level 3—Unobservable inputs which are supported by little or no market activity and that are financial instruments whose values are determined using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.

Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts

recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and six months ended June 30, 2020 and 2019.

As of June 30, 2020 and December 31, 2019, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of the instruments.

The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt.

The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of June 30, 2020 and December 31, 2019 (in thousands):


	Fair Value Measured at June 30, 2020 (unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at June 30, 2020
Assets included in:
Cash and cash equivalents
Money market securities	$	21,544	$	—	$	—	$	21,544
Marketable securities at fair value
U.S. treasury securities		—		5,037		—		5,037

Total fair value	$	21,544	$	5,037	$	—	$	26,581

Liabilities included in:
Contingent consideration	$	—	$	—	$	7,500	$	7,500
Common and preferred stock warrant liability		—		—		10,791		10,791

Total fair value	$	—	$	—	$	18,291	$	18,291



	Fair Value Measured at December 31, 2019
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2019
Assets included in:
Cash and cash equivalents
Money market securities	$	8,901	$	—	$	—	$	8,901
Marketable securities at fair value
Corporate debt securities		—		28,224		—		28,224
Asset-backed securities		—		17,121		—		17,121
U.S. treasury securities		—		5,032		—		5,032
Commercial paper		—		11,974		—		11,974

Total fair value	$	8,901	$	62,351	$	—	$	71,252

Liabilities included in:
Contingent consideration	$	—	$	—	$	13,900	$	13,900
Common and preferred stock warrant liability		—		—		8,919		8,919

Total fair value	$	—	$	—	$	22,819	$	22,819

The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets.

The Company’s portfolio of marketable securities is comprised of commercial paper, asset-backed securities, U.S. treasury securities, and short-term highly liquid, high credit quality corporate debt securities. The fair value for the

available-for-sale

marketable securities is determined based on trade prices in active markets for identical assets (Level 1 inputs) or valuation models using inputs that are observable either directly or indirectly (Level 2 inputs), such as quoted prices for similar assets or liabilities, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments or debt, broker and dealer quotes, as well as other relevant economic measures.

The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands):


	Common and Preferred Stock Warrant Liability		Contingent Consideration			Total
Balance, December 31, 2019	$	8,919	$	13,900		$	22,819
Payment of contingent consideration		—		(2,619	)		(2,619	)
Issuance of preferred stock for contingent consideration		—		(2,197	)		(2,197	)
Change in fair value		1,872		(1,584	)		288

Balance, June 30, 2020 (unaudited)	$	10,791	$	7,500		$	18,291

Unrealized gains and losses associated with liabilities within the Level 3 category include changes in fair value that were attributable to both observable (e.g., changes in market interest rates) and unobservable (e.g., changes in unobservable long-dated volatilities) inputs.

The fair value of the common and preferred stock

warrant liability

has been estimated using a Monte Carlo simulation in the first quarter of 2019 and as an output of the Hybrid Method for the

second quarter

of 2019 and

the first and second

quarter of 2020. The underlying equity included in the Monte Carlo simulation and the Hybrid Method was determined based on the equity value implied from the preferred stock transactions and from examination of income and market approaches for measurement dates in which a preferred transaction was not applicable. Additionally, the expected IPO value was considered in the determination of the equity value. The fair value of the warrants was impacted by the model selected as well as assumptions surrounding unobservable inputs including the underlying equity value, risk-free interest rate, expected dividend yield, contractual term and expected volatility. The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liabilities as of June 30, 2020 and December 31, 2019 were as follows:


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.15% - 0.18%	1.59% - 1.60%
Expected dividend yield	—	—
Contractual term in years	0.2 - 0.5	0.7 - 1.0
Expected volatility	67.0% - 123.0%	60.0% - 110.5%

The fair value of the contingent consideration from the acquisition of Rhythm Xience represents the estimated fair value of future payments due to the sellers of Rhythm Xience based on the achievement of certain milestones and revenue-based targets in certain years. The initial fair value of the revenue-based contingent consideration was calculated through the use of a Monte Carlo simulation using revenue projections for the respective

earn-out

period, corresponding targets and approximate timing of payments as outlined in the purchase agreement. The analyses used the following assumptions: (i) expected term; (ii) risk-adjusted net sales or earnings; (iii) risk-free

interest rate; and (iv) expected volatility of earnings. Estimated payments, as determined through the respective model, were further discounted by a credit spread assumption to account for credit risk. The fair value of the milestones-based contingent consideration was determined by probability weighting and discounting to the respective valuation date at the Company’s cost of debt. The Company’s cost of debt was determined by performing a synthetic credit rating for the Company and selecting yields based on companies with a similar credit rating. The contingent consideration is revalued to fair value each period, and any increase or decrease is recorded in operating loss. The fair value of the contingent consideration may be impacted by certain unobservable inputs, most significantly with regard to discount rates, expected volatility and historical and projected performance. Significant changes to these inputs in isolation could result in a significantly different fair value measurement. The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2020 and December 31, 2019 were as follows:


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.20%	1.60%
Expected term in years	1.0 - 2.0	1.0 - 2.0
Expected volatility	18.3%	11.8%

Stock-Based Compensation

The Company accounts for all stock-based payments to employees and

non-employees,

including grants of stock options, restricted stock awards (“RSAs”) and restricted stock units with

non-market

performance and service conditions (“PSUs”) to be recognized in the condensed consolidated financial statements, based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSAs and PSUs are valued based on the fair value of the Company’s common stock on the date of grant. The assumptions used in calculating the fair value of stock-based awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. The Company expenses stock-based compensation related to stock options and RSAs over the requisite service period. As the PSUs have a performance condition, compensation expense is recognized for each vesting tranche over the respective requisite service period of each tranche if and when the Company’s management deems it probable that the performance conditions will be satisfied. The Company may recognize a cumulative

true-up

adjustment related to PSUs once a condition becomes probable of being satisfied if the related service period had commenced in a prior period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive loss based upon the respective employee’s or

non-employee’s

roles within the Company. Forfeitures are recorded as they occur. See “Note 15—Stock-Based Compensation” below.

Income Taxes

Income taxes are recorded in accordance with ASC 740,

Income Taxes

(“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the condensed consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development (“R&D”) tax credit carryforwards. Valuation allowances are provided if

based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized.

The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.

Warrant Liability

The Company accounts for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815,

Derivatives and Hedging

(“ASC 815”), at fair value. This liability is subject to

re-measurement

at each reporting period until exercised, and any change in fair value is recognized in the condensed consolidated statements of operations and comprehensive loss.

Asset Acquisitions (Research and Development—License Acquired)

The Company accounts for asset acquisitions, where substantially all of the fair value of the assets acquired is concentrated in a group of similar assets (i.e., intellectual property) and therefore the acquisitions do not constitute a business, in accordance with ASC 805,

Business Combinations

(“ASC 805”), under the asset acquisition method. Under the asset acquisition method of accounting, the Company is required to fair value the assets transferred. The cost of the assets acquired, including transaction costs, is allocated to the individual assets acquired based on their relative fair values and does not give rise to goodwill.

Business Combinations

The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill represents the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired. Subsequent adjustments to fair value of any contingent consideration are recorded to the Company’s condensed consolidated statements of operations and comprehensive loss.

Accounting Pronouncements to Be Adopted

In June 2016,

the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”)

No. 2016-13,

Financial Instruments – Credit Losses (Topic 326)

. The ASU sets forth a “current expected credit loss” model which requires the Company to measure all expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. This replaces the existing incurred loss model and is applicable to the measurement of credit losses on financial assets measured at amortized cost,

available-for-sale

debt securities and applies to certain

off-balance

sheet credit exposures. This ASU is effective for smaller reporting companies in calendar year 2023. The Company is currently assessing the impact of the adoption of this ASU on its condensed consolidated financial statements.

In December 2019, the FASB issued ASU

No. 2019-12,

Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes

, which is intended to simplify various aspects related to accounting for income taxes. ASU

No. 2019-12

removes certain exceptions to the general principles in ASC 740 and also clarifies and amends existing guidance to improve consistent application. This guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2020, with early adoption permitted. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements.

In March 2020, the FASB issued ASU No.

2020-04,

Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

, which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform. The new guidance provides optional expedients and exceptions for applying U.S. GAAP to transactions affected by reference rate reform if certain criteria are met. These transactions include: contract modifications, hedging relationships and sale or transfer of debt securities classified as

held-to-maturity.

Entities may apply the provisions of the new standard as of the beginning of the reporting period when the election is made (i.e., as early as the first quarter 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to have been completed. The Company is currently evaluating the impact of this standard on its condensed consolidated financial statements and has yet to elect an adoption date.

Asset Acquisition and Business Combination

6 Months Ended

Jun. 30, 2020

Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]

Asset Acquisition and Business Combination

Note 3—Asset Acquisition and Business Combination

Biotronik Asset Acquisition

In July 2019, the Company entered into a License and Distribution Agreement with the Biotronik Parties to obtain certain licenses to the Biotronik Parties’ patents, whereby the Company acquired certain manufacturing equipment and obtained from the Biotronik Parties a license under certain patents and technology to develop, commercialize, distribute and manufacture the AcQBlate Force ablation catheters and Qubic Force device. In exchange for the rights granted to the Company, the Company made cash payments totaling $10.0 million during the year ended December 31, 2019, and issued 273,070 shares of Series D convertible preferred stock with an implied value of $5.0 million during the six months ended June 30, 2020. The implied value of $5.0 million was recorded as an accrued liability as of December 31, 2019. In accordance with ASC 805, the Biotronik Asset Acquisition

s accounted for as an asset acquisition as substantially all of the $15.0 million value transferred to Biotronik was allocated to intellectual property. On the acquisition date, the products licensed had not yet received regulatory approval and the intellectual property did not have an alternative use. Accordingly, the $15.0 million paid to Biotronik was immediately charged to research and development expense—licensed acquired in the condensed consolidated statement of operations and comprehensive

loss in July 2019.

Additional contingent milestone payments of up to $10.0 million are to be made to the Biotronik Parties contingent upon certain regulatory approvals and first commercial sale. In further consideration of the rights granted, beginning with the Company’s first commercial sale of the first force sensing ablation catheter within the licensed product line, the Company will also make per unit royalty payments. The Company has determined that as of the acquisition date and as of June 30, 2020 and December 31, 2019, the contingent milestone and royalty payments are not probable and estimable and therefore have not been recorded as a liability. Upon regulatory approval of the Company’s force sensing ablation catheter in Europe, the milestone payments will be capitalized and amortized, and the royalty payments will be recorded as cost of products sold as sales of catheters are recognized.

Rhythm Xience Business Combination

On June 18, 2019 (the “Acquisition Date”), the Company acquired an integrated family of transseptal crossing and steerable introducer systems through its acquisition of Rhythm Xience for $3.0 million in cash in exchange for all of the stock of Rhythm Xience (the “Rhythm Xience Acquisition”). The cash payment did not include the potential $17.0 million in earn out consideration, of which $2.0 million was paid with the issuance of Series D convertible preferred stock in February 2020 and the remainder is to be paid based on the achievement of certain regulatory milestones and revenue milestones. In accordance with ASC 805, the Rhythm Xience Acquisition is accounted for as a business combination.

Purchase Price Allocation

The following table summarizes the allocation of the purchase price to the assets acquired and liabilities assumed for the Rhythm Xience Acquisition (in thousands):


Accounts receivable, net	$	3
Prepaid expenses and other current assets		8
Property and equipment, net		3
Intangible assets		4,360
Goodwill		12,026
Contingent consideration		(13,400	)

Cash consideration	$	3,000

The Company recorded $12.0 million of goodwill that arose out of synergies from the Rhythm Xience Acquisition. The Company does not expect goodwill to be deductible for tax purposes.

As part of Rhythm Xience Acquisition, the Company recorded a contingent consideration liability for potential additional payments due to the sellers of Rhythm Xience if certain regulatory approval milestones and revenue milestones are achieved.

The initial

contingent consideration liability of $13.4 million

was

based on the fair value of the contingent consideration liability at the acquisition date. During the six months ended June 30, 2020, the Company issued 119,993 shares of Series D convertible preferred stock and paid $2.6 million of the contingent consideration for the achievement of certain regulatory milestones and revenue milestones. Additionally, the Company recorded a $0.6 million increase and a $1.6 million decrease to the fair value of the contingent consideration liability for the three and six months ended June 30, 2020, respectively, which is included in change in fair value of contingent consideration in

the

condensed consolidated statement of operations and comprehensive loss. There was no change in fair value of the contingent consideration liability recorded for the three and six months ended June 30, 2019. As of June 30, 2020, the contingent consideration liability of $7.5 million is the fair value of the remaining payments due to the sellers of Rhythm Xience if certain additional regulatory approval milestones and revenue milestones are achieved.

Marketable Securities

6 Months Ended

Jun. 30, 2020

Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]

Marketable Securities

Note 4—Marketable Securities

Marketable securities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020 (unaudited)
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term :
U.S. treasury securities	$	5,033	$	4	$	—	$	5,037

Total available-for-sale securities	$	5,033	$	4	$	—	$	5,037


	December 31, 2019
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Corporate debt securities	$	28,204	$	20	$	—	$	28,224
Asset-backed securities		17,108		13		—		17,121
U.S. treasury securities		5,020		12		—		5,032
Commercial paper		11,974		—		—		11,974

Total available-for-sale securities	$	62,306	$	45	$	—	$	62,351

As of June 30, 2020 and December 31, 2019, all of the Company’s

available-for-sale

securities mature in one year or less.

Inventory

6 Months Ended

Jun. 30, 2020

Inventory Disclosure [Abstract]

Inventory

Note 5—Inventory

Inventory as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands):


	June 30, 2020		December 31, 2019
	(unaudited)
Raw materials	$	6,468	$	5,492
Work in process		1,353		1,605
Finish goods		4,445		1,327

Total inventory	$	12,266	$	8,424

Property and Equipment, Net

6 Months Ended

Jun. 30, 2020

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

Note 6—Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020			December 31, 2019
	(unaudited)
Medical diagnostic equipment	$	7,180		$	5,492
Furniture and fixtures		388			159
Office equipment		1,377			1,321
Laboratory equipment and software		3,380			2,807
Leasehold improvements		595			507
Construction in process		102			306

Total property and equipment		13,022			10,592
Less: accumulated depreciation		(5,438	)		(6,165	)

Property and equipment, net	$	7,584		$	4,427

Property and equipment includes certain medical diagnostic equipment, AcQMap Systems, located at customer premises. The Company retains the ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations.

Depreciation expense was $0.6 million and $0.5 million for the three months ended June 30, 2020 and 2019, respectively, and $1.0 million and $1.1 million for the six months ended June 30, 2020 and 2019, respectively.

Goodwill and Intangible Assets

6 Months Ended

Jun. 30, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Note 7—Goodwill and Intangible Assets

The table below summarizes goodwill and intangible assets activities as of June 30, 2020 and December 31, 2019 (in thousands):


	Goodwill		Intangible Assets
Balance at December 31, 2019	$	12,026	$	4,110
Amortization expense		—		(220	)

Balance at June 30, 2020 (unaudited)	$	12,026	$	3,890


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization			June 30, 2020
								(unaudited)
Developed technology	10	9.1	$	4,200	$	(390	)	$	3,810
Trademarks and trade names	0.5	—		60		(60	)		—
Customer-related intangible	5	4		100		(20	)		80

Total			$	4,360	$	(470	)	$	3,890


	Estimated Useful Life (in years)		Weighted Average Remaining Life (in years)		Intangible Assets		Accumulated Amortization			December 31, 2019
	Estimated Useful Life (in years)		Weighted Average Remaining Life (in years)		Intangible Assets		Accumulated Amortization			December 31, 2019
Developed technology		10		9.5	$	3,600	$	(180	)	$	3,420
In-process technology		indefinite				600		—			600
Trademarks and trade names		0.5		—		60		(60	)		—
Customer-related intangible		5		4.5		100		(10	)		90

Total					$	4,360	$	(250	)	$	4,110

Acquired

in-process

technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the

in-process

technology was classified as a finite-lived intangible and amortization for

in-process

technology began. The Company recorded $0.1 million and $0.2 million of amortization expense related to the above intangible assets for the three and six months ended June 30, 2020, respectively. There was no amortization expense related to the above intangible assets for the three and six months ended June 30, 2019.

The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2020 (in thousands):


	Developed Technology		Customer-Related Intangible		Total Amortization
Six months ending December 31, 2020	$	210	$	10	$	220
Year ending December 31, 2021		420		20		440
Year ending December 31, 2022		420		20		440
Year ending December 31, 2023		420		20		440
Year ending December 31, 2024		420		10		430
Thereafter		1,920		—		1,920

Total	$	3,810	$	80	$	3,890

Accrued Liabilities

6 Months Ended

Jun. 30, 2020

Payables and Accruals [Abstract]

Accrued Liabilities

Note 8—Accrued Liabilities

Accrued liabilities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020		December 31, 2019
	(unaudited)
Biotronik Asset Acquisition - accrued purchase price	$	—	$	5,000
Payroll and related expenses		3,869		3,785
Professional fees		1,850		188
Deferred revenue		88		311
Other		1,229		792

Total accrued liabilities	$	7,036	$	10,076

Debt

6 Months Ended

Jun. 30, 2020

Debt Disclosure [Abstract]

Debt

Note 9—Debt

Outstanding debt as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands):


	June 30, 2020			December 31, 2019
	(unaudited)
2019 Credit Agreement (1)	$	44,550		$	44,550

Total debt, gross		44,550			44,550
Less: Unamortized debt discount and fees		(5,992	)		(6,306	)

Total long-term debt	$	38,558		$	38,244

(1)	The 2019 Credit Agreement includes final payment fees of $4.6 million.

2019 Credit Agreement

On May 20, 2019, the Company entered into a Credit Agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining amount of the facility, $10.0 million was available for borrowing by the Company on or prior to June 30, 2020 and $20.0 million is available for borrowing by the Company on or prior to December 31, 2020, in each case subject to the achievement of specified trailing revenue levels. The Company did not achieve the trailing revenue levels to draw the $10.0 million by June 30, 2020 but the $20.0 million remains available for borrowing on or prior to December 31, 2020 if the specified trailing revenue levels are met. The 2019 Credit Agreement bears interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement is due on May 20, 2024. The 2019 Credit Agreement provides for final payment fees of an additional $4.6 million that are due upon prepayment or on the maturity date or upon acceleration.

Upon the occurrence and during an event of default, which includes but is not limited to payment default, covenant default or the occurrence of a material adverse change, the lenders may declare all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10.0% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders may request repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features are an embedded derivative that is separately measured from the loan host instrument and classified with the loan host instrument.

In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.667 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share.

The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which is being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method.

The Company’s obligations under the 2019 Credit Agreement are secured by substantially all of its assets, including its intellectual property, and is guaranteed by Acutus NV. The 2019 Credit Agreement contains customary affirmative and negative covenants, including with respect to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments and merge or consolidate with any other person or engage in transactions with its affiliates, but does not include any financial covenants, other than a minimum liquidity requirement. As of and for the six months ended June 30, 2020 and 2019, the Company was in compliance with all such covenants.

2019 Convertible Notes

On May 20, 2019, the Company sold and issued $37.0 million in aggregate principal amount of convertible promissory notes (the “2019 Convertible Notes”). The 2019 Convertible Notes bore interest at 13% per annum and were due on December 31, 2019. The 2019 Convertible Notes, including accrued interest, automatically convert into preferred stock at the lowest price per share paid by a cash investor in a qualified equity financing of at least $23.0 million (excluding the principal of any debt that is cancelled or converted into preferred stock in the equity financing), which occurred on June 12, 2019. In accordance with ASC 480,

Distinguishing Liabilities from Equity

, the 2019 Convertible Notes were recorded as share-settled debt at fair value. As the 2019 Convertible Notes converted to Series D convertible preferred stock on June 12, 2019, the initial proceeds of $37.0 million is the fair value and the settlement value of the 2019 Convertible Notes.

Operating Leases

6 Months Ended

Jun. 30, 2020

Leases [Abstract]

Operating Leases

Note 10—Operating Leases

The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a noncancelable operating lease that expires on December 31, 2022. The lease is subject to variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the

right-of-use

asset as it is not reasonably certain to be exercised.

The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31. 2021. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional three-year term upon the expiration date of the lease, which has been included in the calculation of the

right-of-use

asset as it is reasonably certain to be exercised.

The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2020 and 2019 (dollars in thousands):


	Six Months Ended June 30,
	2020			2019
	(unaudited)
Operating cash flows used in operating leases	$	507		$	477
Right-of-use assets exchanged for operating lease liabilities	$	—		$	2,978
Weighted-average remaining lease term – operating leases		1.8 years			2.3 years
Weighted-average discount rate – operating leases		7.0	%		7.0	%

The following table provides the components of the Company’s lease cost (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	216	$	216	$	432	$	432
Variable lease cost		92		40		165		104


Total rent expense	$	308	$	256	$	597	$	536

As of June 30, 2020, future minimum payments under the

non-cancelable

operating leases under ASC 842 were as follows (in thousands):


Six months ending December 31, 2020	$	507
Year ending December 31, 2021		1,044
Year ending December 31, 2022		1,074
Year ending December 31, 2023		51
Year ending December 31, 2024		51

Total		2,727
Less: present value discount		(251	)

Operating lease liabilities	$	2,476

Commitments and Contingencies	6 Months Ended
Commitments and Contingencies	Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 11—Commitments and Contingencies The Company is not a party to any material legal proceedings and is not aware of any pending or threatened claims. From time to time however, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities.

Warrants

6 Months Ended

Jun. 30, 2020

Warrants and Rights Note Disclosure [Abstract]

Warrants

Note 12—Warrants

As of June 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following:


	Equity Upon Exercise		Exercise Price		Expiration Date		June 30, 2020		December 31, 2019
							(unaudited)
Warrants issued in 2015		Common Stock	$	5.25		1/30/25		7,616		7,616
Warrants issued with 2018 Convertible Notes		Common Stock	$	0.10		6/7/28		501,946		501,946
Warrants issued with 2018 Term Loan		Series D convertible preferred	$	16.67		7/31/28		26,998		26,998
Warrants issued with 2019 Credit Agreement		Series D convertible preferred	$	16.67		5/20/29		419,992		419,992

Total Warrants								956,552		956,552

The Company has no warrant activity for the six months ended June 30, 2020. The remaining weighted average contractual life is 7.9 years as of June 30, 2020.

Warrants Classified as Liabilities

During 2019, in connection with the Company’s entry into the 2019 Credit Agreement, the Company issued warrants to purchase 419,992 shares of its Series C convertible preferred stock with an exercise price of $16.667 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share. During 2018, in connection with the issuance of the 2018 Convertible Notes and the 2018 Term Loan, the Company issued

ten-year

warrants to purchase 501,946 shares of common stock with an exercise price of $0.10 per share and 26,998 shares of Series C convertible preferred stock with an exercise price of $16.667 per share, respectively. The warrants for Class C convertible preferred stock were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.667 per share.

The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised. In the event of conversion of the Company’s convertible preferred stock into common shares, the warrants become exercisable into common shares of the Company’s stock, subject to certain adjustments.

In accordance with ASC 815, other than the warrants issued in 2015, the warrants are recorded as liabilities at fair value at the issuance date. Changes in the fair value are recognized in change in fair value of warrant liability and embedded derivative in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period.

Warrants Classified as Equity

In accordance with ASC 815, the warrants issued in 2015 do not meet the definition of a derivative and are classified in stockholders’ deficit in the condensed consolidated balance sheets.

Convertible Preferred Stock

6 Months Ended

Jun. 30, 2020

Temporary Equity [Abstract]

Convertible Preferred Stock

Note 13—Convertible Preferred Stock

In February 2020, the Company issued 119,993 shares of its Series D convertible preferred stock with an implied value of $2.2 million in connection with a contingent consideration payment related to the Rhythm Xience Acquisition.

In February 2020, the Company issued 273,070 shares of its Series D convertible preferred stock with an implied value of $5.0 million for the final purchase consideration of the Biotronik Asset Acquisition.

Redemption

The convertible preferred stock

was

not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock

was

contingently redeemable upon certain liquidation events. As redemption by the holders

was

not solely within the control of the Company, all of the outstanding convertible preferred stock is classified as temporary equity in the condensed consolidated balance sheets.

Dividends

The holders of shares of convertible preferred stock

were

entitled to receive dividends, out of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the common stock of the Company, at the applicable dividend rate, payable on a

pro rata

pari passu

basis when, as and if declared by the Company’s board of directors. The dividend rate

was

$0.68 per annum for each share of Series A convertible preferred stock, $1.07 per annum for each share of Series B convertible preferred stock and $1.36 per annum for each share of Series C convertible preferred stock and Series D convertible preferred stock, as adjusted. The dividend rights

were

not cumulative.

Liquidation

The holders of the Series D convertible preferred stock

were

entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but

unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders of the Junior Preferred Stock were entitled to receive a liquidation preference prior to any distribution to the holders of common stock, after payment of the Series D Liquidation Preference, in the amount of the applicable original issue price plus declared but unpaid dividends on such shares.

Conversion

Each share of preferred stock

was

convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessable shares of the Company’s common stock as is determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price per share for each series of convertible preferred stock

was

the original issue price applicable to such series as follows:


Series	Conversion Price
Series A convertible preferred stock	$	8.295
Series B convertible preferred stock	$	13.370
Series C convertible preferred stock	$	16.667
Series D convertible preferred stock	$	16.667

Each share of convertible preferred stock

was

automatically

convertible

into fully-paid,

non-assessable

shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50 million of net

proceeds to the Company.

On August 10, 2020, in connection with the closing of the IPO each outstanding share of Series A, B, C and D convertible preferred stock converted into one share of common stock.

Voting Rights

Holders of convertible preferred stock

had

the right to one vote for each share of common stock into which such preferred stock could then be converted, and with respect to such vote, such holder ha

full voting rights and powers equal to the voting rights and powers of the holders of common stock.

As long as any shares of Series D convertible preferred stock were outstanding, the holders of such shares of Series D convertible preferred stock (voting exclusively as a separate series) were entitled to elect one director. As long as any shares of Series C convertible preferred stock were outstanding, the holders of such shares of Series C convertible preferred stock (voting exclusively as a separate series) were entitled to elect three directors. As long as any shares of Series A convertible preferred stock or Series B convertible preferred stock were outstanding, the holders of such shares (voting together as a single class and not as separate series, and on an as converted basis) were entitled to elect four directors. The holders of outstanding common stock were entitled to elect one director, prior to the conversion of the Series A, B, C and D convertible preferred stock. The holders of convertible preferred stock and common stock (voting together as a single class and not as separate series, and on an

as-converted

basis) were entitled to elect any remaining directors.

Any director may be removed during his or her term of office, either with or without cause, by, and only by, the affirmative vote of the holders of the shares of the class or series of stock entitled to elect such director or directors, given either at a special meeting of such stockholders duly called for that purpose or pursuant to a written consent of stockholders, and any vacancy thereby created may be filled by the holders of that class or series of stock represented at the meeting or pursuant to written consent.

Stockholders' Deficit	6 Months Ended
Stockholders' Deficit	Jun. 30, 2020
Equity [Abstract]
Stockholders' Deficit	Note 14—Stockholders’ Deficit As of December 31, 2019, the Company’s Amended and Restated Certificate of Incorporation authorized the issuance of 220,000,000 shares of common stock, $0.001 par value per share. Each share of common stock is entitled to one voting right. Common stock owners are entitled to dividends when funds are legally available and declared by the Board. On August 10, 2020, the Company filed an amended and restated certificate of incorporation (the “A&R Certificate”) with the Secretary of State of the State of Delaware. The A&R Certificate amended and restated the Company’s authorized shares of common stock to 260,000,000 and authorized shares of undesignated preferred stock to 5,000,000. During the six months ended June 30, 2020 and 2019, stock options to acquire 64,562 and 8,469 shares, respectively, were exercised for shares of common stock. The Company received approximately $0.2 million and $0.1 million for the exercise price of the stock options for the six months ended June 30, 2020 and 2019, respectively.

Stock-Based Compensation

6 Months Ended

Jun. 30, 2020

Share-based Payment Arrangement [Abstract]

Stock-Based Compensation

Note 15—Stock-Based Compensation

The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options,

non-statutory

stock options, restricted stock, restricted stock units and other stock-based awards to employees, directors, officers and consultants. As of June 30, 2020, 3,858,099 shares of common stock were authorized for issuance under the 2011 Plan and 390,912 shares remain available for issuance under the 2011 Plan.

Stock Options

The stock options generally vest over four years and have a

ten-year

contractual term. The fair value of each employee and

non-employee

stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company is a private company as of June 30, 2020 and lacks company-specific historical and implied volatility information. Therefore, it estimates its expected stock volatility based on the historical volatility of a publicly traded set of peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.

The following assumptions were used to estimate the fair value of stock option for the six months ended June 30, 2020 and 2019:


	Six Months Ended June 30,
	2020		2019
	(unaudited)
Risk-free interest rate		0.90%		2.0% - 2.1 %
Expected dividend yield		—		—
Expected term in years		7.0		6.38 - 10.00
Expected volatility		70.0%		80.0%

The following table summarizes stock option activity during the six months ended June 30, 2020:


	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)		Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2019		2,041,205		$	9.52		7.7	$	7,857
Options granted		867,031			14.81
Option exercised		(111,936	)		7.73
Options forfeited		(200,213	)		12.01

Outstanding as of June 30, 2020 (unaudited)		2,596,087		$	11.17		7.8	$	17,816

Options vested and exercisable as of June 30, 2020 (unaud i ted)		1,138,429		$	8.34		6.1	$	11,037

The aggregate intrinsic value in the above table is calculated as the difference between the fair value of the Company’s common stock

as of June 30, 2020

and the exercise price of the stock options. The weighted-average grant date fair value per share for the stock option awards granted during the six months ended June 30, 2020 was $14.81. As of June 30, 2020, the total unrecognized compensation related to unvested stock option awards granted was $13.8 million, which the Company expects to recognize over a weighted-average period of approximately 2.8 years.

Restricted Stock

The Company’s RSA activity for the six months ended June 30, 2020 was as follows:


	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		—		$	—
Granted		14,945			14.81
Vested		(14,945	)		14.81

Unvested as of June 30, 2020 (unaudited)		—		$	—

The following table summarizes the total stock-based compensation expense for the stock options and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Cost of products sold	$	58	$	54	$	166	$	106
Research and development		167		150		378		292
Selling, general and administrative		932		599		2,354		964

Total stock-based compensation	$	1,157	$	803	$	2,898	$	1,362

Performance-Based Restricted Stock Units

In June 2019, the Company granted 567,509 PSUs, with a grant date fair value of $13.37. Vesting of the PSUs is dependent upon the satisfaction of both a service condition and a performance condition, which is an initial public offering or a change of control. As the performance conditions for the PSU were not considered

probable

of June 30, 2020 and 2019,

no compensation expense related to these awards has been recorded for the three and six months ended June 30, 2020 and 2019.

Net Loss Per Common Share

6 Months Ended

Jun. 30, 2020

Earnings Per Share [Abstract]

Net Loss Per Common Share

Note 16—Net Loss Per Common Share

Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. Diluted net loss per common share excludes the potential impact of the Company’s convertible preferred stock, common stock options and warrants because their effect would be anti-dilutive due to the Company’s net loss. Since the Company had a net loss in the periods presented, basic and diluted net loss per common share are the same.

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:


	Six Months Ended June 30,
	2020		2019
Shares issuable upon conversion of Series A Preferred Stock		391,210		391,210
Shares issuable upon conversion of Series B Preferred Stock		3,088,444		3,088,444
Shares issuable upon conversion of Series C Preferred Stock		4,499,921		4,499,921
Shares issuable upon conversion of Series D Preferred Stock		8,593,360		6,418,437
Shares issuable upon exercise of stock options		2,596,087		1,751,616
Shares issuable upon exercise of common stock warrants		509,562		509,562
Shares issuable upon exercise of preferred stock warrants		446,990		446,990

Total		20,125,574		17,106,180

For the six months ended June 30, 2020 and 2019, the PSUs are not included in the above table as awards with performance conditions are not included in the calculation of diluted earnings per share until the performance conditions for the PSU are considered probable.

401(k) Retirement Plan	6 Months Ended
401(k) Retirement Plan	Jun. 30, 2020
Retirement Benefits [Abstract]
401(k) Retirement Plan	Note 17—401(k) Retirement Plan The Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company did not provide any contributions to the 401(k) retirement savings plan for the six months ended June 30, 2020 and 2019.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 55
-Paragraph 17
-URI http://asc.fasb.org/extlink&oid=118257860&loc=d3e4179-114921

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section S99
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=21916913&loc=d3e273930-122802

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-URI http://asc.fasb.org/extlink&oid=118255775&loc=d3e1928-114920

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
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+ Details

Related Party Transactions	6 Months Ended
Related Party Transactions	Jun. 30, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Note 18—Related Party Transactions The Company licenses certain patent rights from a director and shareholder. The license agreement provides for royalty payments to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned were $16,000 and $11,000 for the three months ended June 30, 2020 and 2019 and $37,000 and $23,000 for the six months ended June 30, 2020 and 2019, respectively. Additionally, the director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. The Company recorded sales to this customer of $0.2 million for the three months ended June 30, 2020 and $0.5 million and $0.1 million for the six months ended June 30, 2020 and 2019, respectively. The Company has a consulting agreement with a director and chairman of the Company’s board of directors. The Company recorded $47,000 and $74,000 for the three months ended June 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million for the six months ended June 30, 2020 and 2019, respectively, in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services. The Company had a consulting agreement with an officer of the Company in the prior year. The Company recorded $94,000 for the three months ended June 30, 2019, and $0.2 million for the six months ended June 30, 2019 in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services. The Company had a consulting arrangement with a current director and officer of the Company, prior to his full-time employment. The Company recorded $0.1 million and $0.2 million for the three and six months ended June 30, 2019, respectively in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services. Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million with $40.0 million being drawn as of June 30, 2020. The Company recorded $1.3 million and $0.6 million for the three months ended June 30, 2020 and 2019, respectively, and $2.7 million and $0.6 million for the six months ended June 30, 2020 and 2019, respectively, in interest expense related to these debt agreements.

Subsequent Events	6 Months Ended
Subsequent Events	Jun. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	Note 19—Subsequent Events The Company has completed an evaluation of all subsequent events through September 1 8 , 2020 to ensure that these condensed consolidated financial statements include appropriate disclosure of events both recognized in the condensed consolidated financial statements and events which occurred but were not recognized in the condensed consolidated financial statements. Except as described below, the Company has concluded that no subsequent event has occurred that requires disclosure. Reverse Stock Split The Company’s board of directors approved a reverse split of shares of the Company’s common stock and convertible preferred stock on a 9.724-for-one basis , which was effected on July 28, 2020. The par value and the number of authorized shares of the convertible preferred stock and common stock were not adjusted in connection with the Reverse Stock Split. All references to common stock, convertible preferred stock, warrants to purchase common stock, warrants to purchase convertible preferred stock, options to purchase common stock, restricted stock units, restricted stock awards, share data, per share data and related information contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the effect of the Reverse Stock Split for all periods presented. No fractional shares of the Company’s common stock were issued in connection with the Reverse Stock Split. Any fractional share resulting from the Reverse Stock Split was rounded down to the nearest whole share, and any stockholder entitled to a fractional share as a result of the Reverse Stock Split will receive a cash payment in lieu of receiving fractional shares. Initial Public Offering On August 10, 2020, the Company issued 10,147,058 shares of common stock in its IPO, which included 1,323,529 shares of common stock issued upon the exercise in full by the underwriters of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price to the public for each share was $18.00. On August 10, 2020, in connection with the closing of the IPO, 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock and the warrants to purchase 446,990 shares of Series D convertible preferred stock were automatically converted to an equal number of warrants to purchase common stock at an exercise price of $16.67 per share. As a result of the IPO, the underwriters’ exercise of their option, and the conversions of the Series A, B, C and D convertible preferred stock, the Company’s total number of outstanding shares increased by 26,719,993 immediately following the closing of the IPO. Equity Incentive Plan The 2020 Equity Incentive Plan (“2020 Plan”) which permits the granting of nonstatutory stock options, restricted stock, restricted stock units, stock appreciation rights, performance units, performance shares and other equity-based awards to employees, directors and consultants became effective on August 10, 2020 and 2,193,360 shares of common stock were reserved for issuance under the 2020 Plan. On August 10, 2020, options to purchase 850,217 shares of common stock, 211,251 restricted stock units and 17,976 restricted stock awards under the 2020 Plan were awarded to certain employees and consultants of the Company. The 2020 Employee Stock Purchase Plan (“2020 ESPP”) which permits employees to purchase shares of the Company’s common stock became effective on August 10, 2020 and 387,063 shares of common stock were authorized for sale under the 2020 ESPP.

Summary of Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2020

Accounting Policies [Abstract]

Basis of Presentation

10-Q

and Article 10 of Regulation

S-X.

Principles of Consolidation

Use of Estimates and Assumptions

Segments

Cash and Cash Equivalents and Restricted Cash


	June 30, 2020		December 31, 2019
	(unaudited)
Cash and cash equivalents	$	24,295	$	9,452
Restricted cash		150		150

Total cash, cash equivalents and restricted cash	$	24,445	$	9,602

Marketable Securities

The Company considers its debt securities to be

available-for-sale

securities.

Available-for-sale

available-for-sale

securities and are reported as a component of current assets.

Securities that are classified as

available-for-sale

securities at each period end to determine if they remain

available-for-sale

six-month

periods ended June 30, 2020 and 2019.

Deferred Offering Costs

Concentrations of Credit Risk and Off-Balance Sheet Risk

Concentrations of Credit Risk and

Off-Balance

Sheet Risk

Revenue from Contracts with Customers

The Company accounts for revenue earned from contracts with customers under Accounting Standards Codification (“ASC”) 606,

Revenue from Contracts with Customers

•

Step 1: Identify the contract with the customer.

•

Step 2: Identify the performance obligations in the contract.

•

Step 3: Determine the transaction price.

•

Step 4: Allocate the transaction price to the performance obligations in the contract.

•

Step 5: Recognize revenue when, or as, the company satisfies a performance obligation.

The Company

usually

when-and-if-available


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Disposables	$	1,122	$	730	$	2,179	$	1,512
Systems		—		—	$	520		—
Service/Other		12		4		18		9

Total	$	1,134	$	734	$	2,717	$	1,521

In May 2020, the Company entered into

bi-lateral

distribution agreements with Biotronik SE & Co. KG (“Biotronik”) (the

“Bi-Lateral

Distribution Agreements”). Pursuant to the

Bi-Lateral

Distribution Agreements, the Company obtained a

non-

The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
United States	$	559	$	221	$	1,328	$	456
Europe		575		513		1,389		1,065

Total Revenue	$	1,134	$	734	$	2,717	$	1,521

Inventory

Inventory is comprised of raw materials, direct labor and manufacturing overhead and is stated at the lower of cost

(first-in,

first-out

Accounts Receivable

Property and Equipment, Net

Intangible Assets

Intangible assets consist of acquired developed technology, acquired

in-process

technology was classified as an indefinite-lived intangible asset, until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the

in-process

technology was classified as a finite-lived intangible and amortization for

in-process

lived intangible assets are impaired if their estimated fair values are less than their carrying value.

Goodwill

Intangibles

– Goodwill and Other

Impairment of Long-Lived Assets

Foreign Currency Translation and Transactions

Leases

Effective January 1, 2019, the Company accounts for its leases under ASC 842,

Leases

right-of-use

asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the

right-of-use

asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the

right-of-use

asset and lease liability, the Company elects to combine lease and

non-lease

components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election.

Cost of Products Sold

Research and Development

know-how

rights and equipment (the “Biotronik Asset Acquisition”).

Selling, General and Administrative

Fair Value Measurements

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.


	Fair Value Measured at June 30, 2020 (unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at June 30, 2020
Assets included in:
Cash and cash equivalents
Money market securities	$	21,544	$	—	$	—	$	21,544
Marketable securities at fair value
U.S. treasury securities		—		5,037		—		5,037

Total fair value	$	21,544	$	5,037	$	—	$	26,581

Liabilities included in:
Contingent consideration	$	—	$	—	$	7,500	$	7,500
Common and preferred stock warrant liability		—		—		10,791		10,791

Total fair value	$	—	$	—	$	18,291	$	18,291



	Fair Value Measured at December 31, 2019
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2019
Assets included in:
Cash and cash equivalents
Money market securities	$	8,901	$	—	$	—	$	8,901
Marketable securities at fair value
Corporate debt securities		—		28,224		—		28,224
Asset-backed securities		—		17,121		—		17,121
U.S. treasury securities		—		5,032		—		5,032
Commercial paper		—		11,974		—		11,974

Total fair value	$	8,901	$	62,351	$	—	$	71,252

Liabilities included in:
Contingent consideration	$	—	$	—	$	13,900	$	13,900
Common and preferred stock warrant liability		—		—		8,919		8,919

Total fair value	$	—	$	—	$	22,819	$	22,819

The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets.

available-for-sale

The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands):


	Common and Preferred Stock Warrant Liability		Contingent Consideration			Total
Balance, December 31, 2019	$	8,919	$	13,900		$	22,819
Payment of contingent consideration		—		(2,619	)		(2,619	)
Issuance of preferred stock for contingent consideration		—		(2,197	)		(2,197	)
Change in fair value		1,872		(1,584	)		288

Balance, June 30, 2020 (unaudited)	$	10,791	$	7,500		$	18,291

The fair value of the common and preferred stock

warrant liability

has been estimated using a Monte Carlo simulation in the first quarter of 2019 and as an output of the Hybrid Method for the

second quarter

of 2019 and

the first and second


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.15% - 0.18%	1.59% - 1.60%
Expected dividend yield	—	—
Contractual term in years	0.2 - 0.5	0.7 - 1.0
Expected volatility	67.0% - 123.0%	60.0% - 110.5%

earn-out


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.20%	1.60%
Expected term in years	1.0 - 2.0	1.0 - 2.0
Expected volatility	18.3%	11.8%

Stock-Based Compensation

The Company accounts for all stock-based payments to employees and

non-employees,

including grants of stock options, restricted stock awards (“RSAs”) and restricted stock units with

non-market

true-up

non-employee’s

roles within the Company. Forfeitures are recorded as they occur. See “Note 15—Stock-Based Compensation” below.

Income Taxes

Income taxes are recorded in accordance with ASC 740,

Income Taxes

based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized.

Warrant Liability

The Company accounts for certain common stock warrants and convertible preferred stock warrants outstanding as a liability, in accordance with ASC 815,

Derivatives and Hedging

(“ASC 815”), at fair value. This liability is subject to

re-measurement

at each reporting period until exercised, and any change in fair value is recognized in the condensed consolidated statements of operations and comprehensive loss.

Asset Acquisitions (Research and Development—License Acquired)

Business Combinations

Accounting Pronouncements to Be Adopted

In June 2016,

the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”)

No. 2016-13,

Financial Instruments – Credit Losses (Topic 326)

available-for-sale

debt securities and applies to certain

off-balance

In December 2019, the FASB issued ASU

No. 2019-12,

Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes

, which is intended to simplify various aspects related to accounting for income taxes. ASU

No. 2019-12

In March 2020, the FASB issued ASU No.

2020-04,

Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

held-to-maturity.

Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2020

Summary Of Significant Accounting Policies [Line Items]

Summary of Cash and Cash Equivalents and Restricted Cash


	June 30, 2020		December 31, 2019
	(unaudited)
Cash and cash equivalents	$	24,295	$	9,452
Restricted cash		150		150

Total cash, cash equivalents and restricted cash	$	24,445	$	9,602

Summary of Disaggregation of Revenue

The following table sets forth the Company’s revenue for disposables and systems/service for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Disposables	$	1,122	$	730	$	2,179	$	1,512
Systems		—		—	$	520		—
Service/Other		12		4		18		9

Total	$	1,134	$	734	$	2,717	$	1,521

Summary of Revenue from External Customers by Geographic Areas

The following table provides revenue by geographic location for the three and six months ended June 30, 2020 and 2019 (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
United States	$	559	$	221	$	1,328	$	456
Europe		575		513		1,389		1,065

Total Revenue	$	1,134	$	734	$	2,717	$	1,521

Summary of Fair Value, Liabilities Measured on Recurring Basis


	Fair Value Measured at June 30, 2020 (unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at June 30, 2020
Assets included in:
Cash and cash equivalents
Money market securities	$	21,544	$	—	$	—	$	21,544
Marketable securities at fair value
U.S. treasury securities		—		5,037		—		5,037

Total fair value	$	21,544	$	5,037	$	—	$	26,581

Liabilities included in:
Contingent consideration	$	—	$	—	$	7,500	$	7,500
Common and preferred stock warrant liability		—		—		10,791		10,791

Total fair value	$	—	$	—	$	18,291	$	18,291



	Fair Value Measured at December 31, 2019
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2019
Assets included in:
Cash and cash equivalents
Money market securities	$	8,901	$	—	$	—	$	8,901
Marketable securities at fair value
Corporate debt securities		—		28,224		—		28,224
Asset-backed securities		—		17,121		—		17,121
U.S. treasury securities		—		5,032		—		5,032
Commercial paper		—		11,974		—		11,974

Total fair value	$	8,901	$	62,351	$	—	$	71,252

Liabilities included in:
Contingent consideration	$	—	$	—	$	13,900	$	13,900
Common and preferred stock warrant liability		—		—		8,919		8,919

Total fair value	$	—	$	—	$	22,819	$	22,819

Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

The following table presents changes in Level 3 liabilities measured at fair value for the six months ended June 30, 2020 (in thousands):


	Common and Preferred Stock Warrant Liability		Contingent Consideration			Total
Balance, December 31, 2019	$	8,919	$	13,900		$	22,819
Payment of contingent consideration		—		(2,619	)		(2,619	)
Issuance of preferred stock for contingent consideration		—		(2,197	)		(2,197	)
Change in fair value		1,872		(1,584	)		288

Balance, June 30, 2020 (unaudited)	$	10,791	$	7,500		$	18,291

Weighted-average unobservable inputs to measure contingent consideration

The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liabilities as of June 30, 2020 and December 31, 2019 were as follows:


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.15% - 0.18%	1.59% - 1.60%
Expected dividend yield	—	—
Contractual term in years	0.2 - 0.5	0.7 - 1.0
Expected volatility	67.0% - 123.0%	60.0% - 110.5%

Weighted-average unobservable inputs to measure contingent consideration

The weighted-average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of June 30, 2020 and December 31, 2019 were as follows:


	June 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.20%	1.60%
Expected term in years	1.0 - 2.0	1.0 - 2.0
Expected volatility	18.3%	11.8%

Asset Acquisition and Business Combination (Tables)

6 Months Ended

Jun. 30, 2020

Business Combination, Recognized Identifiable Assets Acquired, Goodwill, and Liabilities Assumed, Net [Abstract]

Summary of Purchase Price Allocation To The Assets Acquired and Liabilities Assumed

The following table summarizes the allocation of the purchase price to the assets acquired and liabilities assumed for the Rhythm Xience Acquisition (in thousands):


Accounts receivable, net	$	3
Prepaid expenses and other current assets		8
Property and equipment, net		3
Intangible assets		4,360
Goodwill		12,026
Contingent consideration		(13,400	)

Cash consideration	$	3,000

Marketable Securities (Tables)

6 Months Ended

Jun. 30, 2020

Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]

Summary of Marketable Securities

Marketable securities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020 (unaudited)
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term :
U.S. treasury securities	$	5,033	$	4	$	—	$	5,037

Total available-for-sale securities	$	5,033	$	4	$	—	$	5,037


	December 31, 2019
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Corporate debt securities	$	28,204	$	20	$	—	$	28,224
Asset-backed securities		17,108		13		—		17,121
U.S. treasury securities		5,020		12		—		5,032
Commercial paper		11,974		—		—		11,974

Total available-for-sale securities	$	62,306	$	45	$	—	$	62,351

Inventory (Tables)

6 Months Ended

Jun. 30, 2020

Inventory Disclosure [Abstract]

Summary of Inventory

Inventory as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands):


	June 30, 2020		December 31, 2019
	(unaudited)
Raw materials	$	6,468	$	5,492
Work in process		1,353		1,605
Finish goods		4,445		1,327

Total inventory	$	12,266	$	8,424

Property and Equipment, Net (Tables)

6 Months Ended

Jun. 30, 2020

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020			December 31, 2019
	(unaudited)
Medical diagnostic equipment	$	7,180		$	5,492
Furniture and fixtures		388			159
Office equipment		1,377			1,321
Laboratory equipment and software		3,380			2,807
Leasehold improvements		595			507
Construction in process		102			306

Total property and equipment		13,022			10,592
Less: accumulated depreciation		(5,438	)		(6,165	)

Property and equipment, net	$	7,584		$	4,427

Goodwill and Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Summary Of Goodwill And Intangible Assets Activities

The table below summarizes goodwill and intangible assets activities as of June 30, 2020 and December 31, 2019 (in thousands):


	Goodwill		Intangible Assets
Balance at December 31, 2019	$	12,026	$	4,110
Amortization expense		—		(220	)

Balance at June 30, 2020 (unaudited)	$	12,026	$	3,890


	Estimated Useful Life (in years)	Weighted Average Remaining Life (in years)	Intangible Assets		Accumulated Amortization			June 30, 2020
								(unaudited)
Developed technology	10	9.1	$	4,200	$	(390	)	$	3,810
Trademarks and trade names	0.5	—		60		(60	)		—
Customer-related intangible	5	4		100		(20	)		80

Total			$	4,360	$	(470	)	$	3,890


	Estimated Useful Life (in years)		Weighted Average Remaining Life (in years)		Intangible Assets		Accumulated Amortization			December 31, 2019
	Estimated Useful Life (in years)		Weighted Average Remaining Life (in years)		Intangible Assets		Accumulated Amortization			December 31, 2019
Developed technology		10		9.5	$	3,600	$	(180	)	$	3,420
In-process technology		indefinite				600		—			600
Trademarks and trade names		0.5		—		60		(60	)		—
Customer-related intangible		5		4.5		100		(10	)		90

Total					$	4,360	$	(250	)	$	4,110

Summary Of Remaining Amortization Expense

The following table shows the remaining amortization expense associated with amortizable intangible assets as of June 30, 2020 (in thousands):


	Developed Technology		Customer-Related Intangible		Total Amortization
Six months ending December 31, 2020	$	210	$	10	$	220
Year ending December 31, 2021		420		20		440
Year ending December 31, 2022		420		20		440
Year ending December 31, 2023		420		20		440
Year ending December 31, 2024		420		10		430
Thereafter		1,920		—		1,920

Total	$	3,810	$	80	$	3,890

Accrued Liabilities (Tables)

6 Months Ended

Jun. 30, 2020

Payables and Accruals [Abstract]

Summary Of Accrued Liabilities

Accrued liabilities consisted of the following as of June 30, 2020 and December 31, 2019 (in thousands):


	June 30, 2020		December 31, 2019
	(unaudited)
Biotronik Asset Acquisition - accrued purchase price	$	—	$	5,000
Payroll and related expenses		3,869		3,785
Professional fees		1,850		188
Deferred revenue		88		311
Other		1,229		792

Total accrued liabilities	$	7,036	$	10,076

Debt (Tables)

6 Months Ended

Jun. 30, 2020

Debt Instruments [Abstract]

Summary Of Outstanding Debt

Outstanding debt as of June 30, 2020 and December 31, 2019 consisted of the following (in thousands):


	June 30, 2020			December 31, 2019
	(unaudited)
2019 Credit Agreement (1)	$	44,550		$	44,550

Total debt, gross		44,550			44,550
Less: Unamortized debt discount and fees		(5,992	)		(6,306	)

Total long-term debt	$	38,558		$	38,244

(1)	The 2019 Credit Agreement includes final payment fees of $4.6 million.

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 835
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-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=119993939&loc=d3e28541-108399

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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
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-Paragraph 7
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-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

Operating Leases (Tables)

6 Months Ended

Jun. 30, 2020

Leases [Abstract]

Summary Of Quantitative Information About Operating Leases

The following table summarizes quantitative information about the Company’s operating leases for the six months ended June 30, 2020 and 2019 (dollars in thousands):


	Six Months Ended June 30,
	2020			2019
	(unaudited)
Operating cash flows used in operating leases	$	507		$	477
Right-of-use assets exchanged for operating lease liabilities	$	—		$	2,978
Weighted-average remaining lease term – operating leases		1.8 years			2.3 years
Weighted-average discount rate – operating leases		7.0	%		7.0	%

Summary Of Components Of Lease Cost

The following table provides the components of the Company’s lease cost (in thousands):


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	216	$	216	$	432	$	432
Variable lease cost		92		40		165		104


Total rent expense	$	308	$	256	$	597	$	536

Summary Of Future Minimum Payments Under The Non-cancelable Operating Leases

As of June 30, 2020, future minimum payments under the

non-cancelable

operating leases under ASC 842 were as follows (in thousands):


Six months ending December 31, 2020	$	507
Year ending December 31, 2021		1,044
Year ending December 31, 2022		1,074
Year ending December 31, 2023		51
Year ending December 31, 2024		51

Total		2,727
Less: present value discount		(251	)

Operating lease liabilities	$	2,476

Warrants (Tables)

6 Months Ended

Jun. 30, 2020

Warrants and Rights Note Disclosure [Abstract]

Schedule of Outstanding Warrants to Purchase the Company's Common Stock

As of June 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following:


	Equity Upon Exercise		Exercise Price		Expiration Date		June 30, 2020		December 31, 2019
							(unaudited)
Warrants issued in 2015		Common Stock	$	5.25		1/30/25		7,616		7,616
Warrants issued with 2018 Convertible Notes		Common Stock	$	0.10		6/7/28		501,946		501,946
Warrants issued with 2018 Term Loan		Series D convertible preferred	$	16.67		7/31/28		26,998		26,998
Warrants issued with 2019 Credit Agreement		Series D convertible preferred	$	16.67		5/20/29		419,992		419,992

Total Warrants								956,552		956,552

Convertible Preferred Stock (Tables)

6 Months Ended

Jun. 30, 2020

Temporary Equity [Abstract]

Schedule of Initial Conversion Price per Share for each Series of Convertible Preferred Stock

The initial conversion price per share for each series of convertible preferred stock

was

the original issue price applicable to such series as follows:


Series	Conversion Price
Series A convertible preferred stock	$	8.295
Series B convertible preferred stock	$	13.370
Series C convertible preferred stock	$	16.667
Series D convertible preferred stock	$	16.667

Stock-Based Compensation (Tables)

6 Months Ended

Jun. 30, 2020

Share-based Payment Arrangement [Abstract]

Schedule of Estimate of the Fair Value of Stock Option

The following assumptions were used to estimate the fair value of stock option for the six months ended June 30, 2020 and 2019:


	Six Months Ended June 30,
	2020		2019
	(unaudited)
Risk-free interest rate		0.90%		2.0% - 2.1 %
Expected dividend yield		—		—
Expected term in years		7.0		6.38 - 10.00
Expected volatility		70.0%		80.0%

Summary of Stock Option Activity

The following table summarizes stock option activity during the six months ended June 30, 2020:


	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)		Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2019		2,041,205		$	9.52		7.7	$	7,857
Options granted		867,031			14.81
Option exercised		(111,936	)		7.73
Options forfeited		(200,213	)		12.01

Outstanding as of June 30, 2020 (unaudited)		2,596,087		$	11.17		7.8	$	17,816

Options vested and exercisable as of June 30, 2020 (unaud i ted)		1,138,429		$	8.34		6.1	$	11,037

Schedule of RSA Activity

The Company’s RSA activity for the six months ended June 30, 2020 was as follows:


	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		—		$	—
Granted		14,945			14.81
Vested		(14,945	)		14.81

Unvested as of June 30, 2020 (unaudited)		—		$	—

Summary of the Total Stock-Based Compensation Expense for the Stock Options and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss


	Three Months Ended June 30,				Six Months Ended June 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Cost of products sold	$	58	$	54	$	166	$	106
Research and development		167		150		378		292
Selling, general and administrative		932		599		2,354		964

Total stock-based compensation	$	1,157	$	803	$	2,898	$	1,362

Net Loss Per Common Share (Tables)

6 Months Ended

Jun. 30, 2020

Earnings Per Share [Abstract]

Summary of Calculation of the Diluted Net Loss per Common Share

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:


	Six Months Ended June 30,
	2020		2019
Shares issuable upon conversion of Series A Preferred Stock		391,210		391,210
Shares issuable upon conversion of Series B Preferred Stock		3,088,444		3,088,444
Shares issuable upon conversion of Series C Preferred Stock		4,499,921		4,499,921
Shares issuable upon conversion of Series D Preferred Stock		8,593,360		6,418,437
Shares issuable upon exercise of stock options		2,596,087		1,751,616
Shares issuable upon exercise of common stock warrants		509,562		509,562
Shares issuable upon exercise of preferred stock warrants		446,990		446,990

Total		20,125,574		17,106,180

Organization and Description of Business - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands			6 Months Ended
	Aug. 10, 2020	Jul. 28, 2020	Jun. 30, 2020	Dec. 31, 2019
Common stock shares outstanding			775,403	695,902
Accumulated deficit			$ (300,325)	$ (259,034)
Working capital deficit			$ 15,100	$ 50,500
Subsequent Event [Member]
Reverse stock split		common stock and convertible preferred stock on a 9.724-for-one basis
Share price	$ 18.00
Common stock shares outstanding	26,719,993
IPO [Member] \| Subsequent Event [Member]
Shares issued during the period,shares	10,147,058
Over-Allotment Option [Member] \| Subsequent Event [Member]
Shares issued during the period,shares	1,323,529
Series A Convertible Preferred Stock [Member] \| Subsequent Event [Member]
Conversion of stock shares converted	391,210
Series B Convertible Preferred Stock [Member] \| Subsequent Event [Member]
Conversion of stock shares converted	3,088,444
Series C Convertible Preferred Stock [Member] \| Subsequent Event [Member]
Conversion of stock shares converted	4,499,921
Series D Convertible Preferred Stock [Member]
Shares issued during the period,shares			273,070
Series D Convertible Preferred Stock [Member] \| Subsequent Event [Member]
Conversion of stock shares converted	8,593,360
Excercise price of each warrant	$ 16.67
Class of warrants number of securities called by the warrants or rights	446,990

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019	Jun. 30, 2019	Dec. 31, 2018
Summary Of Significant Accounting Policies [Line Items]
Cash and cash equivalents	$ 24,295	$ 9,452
Restricted cash	150	150
Total cash, cash equivalents and restricted cash	$ 24,445	$ 9,602	$ 68,206	$ 9,775

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total	$ 1,134	$ 734	$ 2,717	$ 1,521
Disposables [Member]
Summary Of Significant Accounting Policies [Line Items]
Total	1,122	730	2,179	1,512
Systems [Member]
Summary Of Significant Accounting Policies [Line Items]
Total			520
Product and Service, Other [Member]
Summary Of Significant Accounting Policies [Line Items]
Total	$ 12	$ 4	$ 18	$ 9

- Definition

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130545-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 280
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 606
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

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-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
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-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI http://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 1,134	$ 734	$ 2,717	$ 1,521
United States
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	559	221	1,328	456
Europe [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 575	$ 513	$ 1,389	$ 1,065

- Definition

+ References

+ Details

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Assets
Total Assets Fair Value	$ 26,581	$ 71,252
Liabilities
Total Liabilities Fair Value	18,291	22,819
Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,500	13,900
Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value	10,791	8,919
money Market Securities [Member]
Assets
Cash and cash equivalents, fair value disclosure	21,544	8,901
Corporate Debt Securities [Member]
Assets
Marketable securities		28,224
Asset-backed Securities [Member]
Assets
Marketable securities		17,121
US Treasury Securities [Member]
Assets
Marketable securities	5,037	5,032
Commercial Paper [Member]
Assets
Marketable securities		11,974
Fair Value, Inputs, Level 1 [Member]
Assets
Marketable securities	21,544
Total Assets Fair Value		8,901
Fair Value, Inputs, Level 1 [Member] \| money Market Securities [Member]
Assets
Cash and cash equivalents, fair value disclosure	21,544	8,901
Fair Value, Inputs, Level 2 [Member]
Assets
Marketable securities	5,037
Total Assets Fair Value		62,351
Fair Value, Inputs, Level 2 [Member] \| Corporate Debt Securities [Member]
Assets
Marketable securities		28,224
Fair Value, Inputs, Level 2 [Member] \| Asset-backed Securities [Member]
Assets
Marketable securities		17,121
Fair Value, Inputs, Level 2 [Member] \| US Treasury Securities [Member]
Assets
Marketable securities	5,037	5,032
Fair Value, Inputs, Level 2 [Member] \| Commercial Paper [Member]
Assets
Marketable securities		11,974
Fair Value, Inputs, Level 3 [Member]
Liabilities
Total Liabilities Fair Value	18,291	22,819
Fair Value, Inputs, Level 3 [Member] \| Contingent Consideration [Member]
Liabilities
Total Liabilities Fair Value	7,500	13,900
Fair Value, Inputs, Level 3 [Member] \| Common and Preferred Stock Warrant Liability [Member]
Liabilities
Total Liabilities Fair Value	$ 10,791	$ 8,919

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2020
Summary Of Significant Accounting Policies [Line Items]
Change in fair value	$ (635)	$ 1,584
Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		22,819
Payment of contingent consideration		(2,619)
Issuance of preferred stock for contingent consideration		(2,197)
Change in fair value		288
Ending Balance, June 30, 2020	18,291	18,291
Common and Preferred Stock Warrant Liability [Member] \| Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		8,919
Change in fair value		1,872
Ending Balance, June 30, 2020	10,791	10,791
Contingent Consideration [Member] \| Fair Value, Inputs, Level 3 [Member]
Summary Of Significant Accounting Policies [Line Items]
Beginning Balance, December 31, 2019		13,900
Payment of contingent consideration		(2,619)
Issuance of preferred stock for contingent consideration		(2,197)
Change in fair value		(1,584)
Ending Balance, June 30, 2020	$ 7,500	$ 7,500

Summary of Significant Accounting Policies - Summary of Weighted Average Fair Value Assumptions on Common and Preferred Stock Warrant Liabilities (Detail) - Fair Value, Inputs, Level 3 [Member]	Jun. 30, 2020	Dec. 31, 2019
Minimum [Member] \| Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.0015	0.0159
Minimum [Member] \| Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	2 months 12 days	8 months 12 days
Minimum [Member] \| Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.67	0.6
Maximum [Member] \| Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	0.0018	0.016
Maximum [Member] \| Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	6 months	1 year
Maximum [Member] \| Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Common and preferred stock warrant liabilities, Fair value inputs	1.23	1.105

Summary of Significant Accounting Policies - Summary of Weighted Average Fair Value Assumptions on Contingent Consideration (Detail) - Fair Value, Inputs, Level 3 [Member] - Rhythm Xience [Member]	Jun. 30, 2020 yr	Dec. 31, 2019 yr
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.002	0.016
Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	0.183	0.118
Minimum [Member] \| Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	1.0	1.0
Maximum [Member] \| Measurement Input, Maturity [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Contingent consideration from the acquisition, Fair value inputs	2.0	2.0

Summary of Significant Accounting Policies - Additional information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Accounting Policies [Abstract]
Inventory Write-down	$ 100	$ 100	$ 100	$ 200
Cash, FDIC insured amount	$ 250		$ 250

Asset Acquisition and Business Combination - Purchase Price Allocation (Detail) - USD ($) $ in Thousands		6 Months Ended
	Jun. 18, 2019	Jun. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill		$ 12,026	$ 12,026
Rhythm Xience [Member]
Business Acquisition [Line Items]
Accounts receivable, net		3
Prepaid expenses and other current assets		8
Property and equipment, net		3
Intangible assets		4,360
Goodwill		12,026
Contingent consideration	$ (7,500)	(13,400)
Cash consideration	$ 3,000	$ 3,000

Asset Acquisition and Business Combination - Additional Information (Detail) - USD ($) $ in Thousands		1 Months Ended	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 18, 2019	Feb. 29, 2020	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Research and development expense			$ 8,176	$ 5,247	$ 16,149	$ 9,624
Goodwill			12,026		12,026		$ 12,026
Payments for contingent consideration					2,619
Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Consideration paid in cash							10,000
Equity interests issued and issuable							$ 5,000
Consideration transferred					15,000
Potential milestone payments payable			10,000		10,000
Biotronik Asset Acquisition [Member] \| Intellectual Property [Member]
Business Acquisition [Line Items]
Research and development expense					15,000
Rhythm Xience [Member]
Business Acquisition [Line Items]
Consideration paid in cash	$ 3,000				3,000
Contingent consideration liability	$ 7,500		13,400		13,400
Date of business acquisition	Jun. 18, 2019
Goodwill			12,026		12,026
Payments for contingent consideration					2,600
Business combination contingent consideration liability change in amount			$ 600	$ 0	1,600	$ 0
Rhythm Xience [Member] \| Earnout Consideration [Member]
Business Acquisition [Line Items]
Potential milestone payments payable	$ 17,000
Series D Convertible Preferred Stock [Member] \| Biotronik Asset Acquisition [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable							273,070
Equity interests issued and issuable					$ 5,000
Series D Convertible Preferred Stock [Member] \| Rhythm Xience [Member]
Business Acquisition [Line Items]
Business consideration, number of equity interests issued and issuable					119,993
Series D Convertible Preferred Stock [Member] \| Rhythm Xience [Member] \| Earnout Consideration [Member]
Business Acquisition [Line Items]
Equity interests issued and issuable		$ 2,000

Marketable Securities - Summary of Marketable Securities (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 5,033	$ 62,306
Gross Unrealized Gains	4	45
Fair Value	5,037	62,351
U.S. treasury securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	5,033	5,020
Gross Unrealized Gains	4	12
Fair Value	$ 5,037	5,032
Corporate debt securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		28,204
Gross Unrealized Gains		20
Fair Value		28,224
Asset-backed securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		17,108
Gross Unrealized Gains		13
Fair Value		17,121
Commercial paper [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		11,974
Fair Value		$ 11,974

Inventory - Summary of Inventory (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Inventory [Line Items]
Raw materials	$ 6,468	$ 5,492
Work in process	1,353	1,605
Finish goods	4,445	1,327
Total inventory	$ 12,266	$ 8,424

Property and Equipment, Net - Summary Of Property And Equipment, Net (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 13,022	$ 10,592
Less: accumulated depreciation	(5,438)	(6,165)
Property and equipment, net	7,584	4,427
Medical diagnostic equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	7,180	5,492
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	388	159
Office equipment [Membre]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,377	1,321
Laboratory equipment and software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	3,380	2,807
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	595	507
Construction in process [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 102	$ 306

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Property, Plant and Equipment [Abstract]
Depreciation	$ 600	$ 500	$ 978	$ 1,142

Goodwill and Intangible Assets - Summary Of Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Indefinite-lived Intangible Assets [Line Items]
Goodwill	$ 12,026		$ 12,026		$ 12,026
Intangible Assets, Gross	4,360		4,360		4,360
Intangible Assets - Balance at December 31, 2019			4,110
Accumulated Amortization	(470)		(470)		(250)
Amortization expense	(100)	$ 0	(220)	$ 0
Intangible Assets - Balance at June 30, 2020	3,890		$ 3,890		$ 4,110
Developed technology [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			10 years		10 years
Weighted Average Remaining Life			9 years 1 month 6 days		9 years 6 months
Intangible Assets, Gross	4,200		$ 4,200		$ 3,600
Intangible Assets - Balance at December 31, 2019			3,420
Accumulated Amortization	(390)		(390)		(180)
Intangible Assets - Balance at June 30, 2020	3,810		$ 3,810		3,420
In-process technology [Member]
Indefinite-lived Intangible Assets [Line Items]
Intangible Assets					$ 600
Trademarks and trade names [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			6 months		6 months
Intangible Assets, Gross	60		$ 60		$ 60
Accumulated Amortization	(60)		$ (60)		$ (60)
Customer-related intangible [Member]
Indefinite-lived Intangible Assets [Line Items]
Estimated Useful Life			5 years		5 years
Weighted Average Remaining Life			4 years		4 years 6 months
Intangible Assets, Gross	100		$ 100		$ 100
Intangible Assets - Balance at December 31, 2019			90
Accumulated Amortization	(20)		(20)		(10)
Intangible Assets - Balance at June 30, 2020	$ 80		$ 80		$ 90

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 100	$ 0	$ 220	$ 0

Goodwill and Intangible Assets - Summary of remaining amortization expense associated with amortizable intangible assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	May 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	$ 220
Year ending December 31, 2021	440
Year ending December 31, 2022	440
Year ending December 31, 2023	440
Year ending December 31, 2024	430
Thereafter	1,920
Total	3,890	$ 4,110	$ 4,110
Developed technology [Member]
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	210
Year ending December 31, 2021	420
Year ending December 31, 2022	420
Year ending December 31, 2023	420
Year ending December 31, 2024	420
Thereafter	1,920
Total	3,810		3,420
Customer-Related Intangible [Member]
Finite-Lived Intangible Assets [Line Items]
Six months ending December 31, 2020	10
Year ending December 31, 2021	20
Year ending December 31, 2022	20
Year ending December 31, 2023	20
Year ending December 31, 2024	10
Thereafter	0
Total	$ 80		$ 90

Accrued Liabilities - Summary Of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Biotronik Asset Acquisition—accrued purchase price		$ 5,000
Payroll and related expenses	$ 3,869	3,785
Professional fees	1,850	188
Deferred revenue	88	311
Other	1,229	792
Total accrued liabilities	$ 7,036	$ 10,076

Debt - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions			6 Months Ended
	Jun. 12, 2019	May 20, 2019	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Convertible Notes Payable
Debt Instrument [Line Items]
Debt instrument, face amount		$ 37.0
Debt instrument, interest rate		13.00%
Long-term debt, date date		Dec. 31, 2019
Debt conversion converted instrument amount	$ 23.0
Series D Convertible Preferred Stock \| 2019 Convertible Notes
Debt Instrument [Line Items]
Proceeds from issuance of convertible preferred stock, net of issuance costs	$ 37.0
Two Thousand And Nineteen Credit Agreement
Debt Instrument [Line Items]
Debt instrument, fee amount			$ 4.6		$ 4.6
Warrants liability fair value			$ 0.9
Class of warrants number of securities called by the warrants or rights			419,992
Warrant liability and direct fees			$ 1.2
Two Thousand And Nineteen Credit Agreement \| Series C Convertible Preferred Stock
Debt Instrument [Line Items]
Debt instrument, interest rate term			7.75% plus LIBOR
Class of warrants, exercise price			$ 16.667
Two Thousand And Nineteen Credit Agreement \| Series D Convertible Preferred Stock
Debt Instrument [Line Items]
Class of warrants, exercise price			$ 16.667
Two Thousand And Nineteen Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Debt instrument, face amount		$ 70.0
Proceeds from senior term loan		$ 40.0
Long-term debt, date date			May 20, 2024
Debt instrument, fee amount			$ 4.6
Debt instrument, Initial debt discount before inception			6.7
Two Thousand And Nineteen Credit Agreement \| Senior Term Loan \| Specified Training Revenue Level One
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity			$ 10.0
Two Thousand And Nineteen Credit Agreement \| Senior Term Loan \| Specified Training Revenue Level Two
Debt Instrument [Line Items]
Debt instrument unused borrowing capacity				$ 20.0
Default Event \| Senior Term Loan
Debt Instrument [Line Items]
Debt instrument, interest rate, increase (decrease)			10.00%

Debt - Summary Of Outstanding Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550
Less: Unamortized debt discount and fees	(5,992)	(6,306)
Total long-term debt	38,558	38,244
Two Thousand And Nineteen Convertible Notes [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 44,550	$ 44,550

Operating Leases - Additional Information (Detail)	6 Months Ended
Operating Leases - Additional Information (Detail)	Jun. 30, 2020 ft²
Lessee, Lease, Description [Line Items]
Office space	50,800
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Lease expiration date	Dec. 31, 2022
Office Space And Manufacturing Facility
Lessee, Lease, Description [Line Items]
Operating lease option to extend renewal term description	five-year term
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space	3,900
Lease expiration date	Dec. 31, 2021
Operating lease option to extend renewal term description	three-year term

Operating Leases - Summary Of Quantitative Information About Operating Leases (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Lessee Disclosure [Abstract]
Operating cash flows used in operating leases	$ 507	$ 477
Right-of-use assets exchanged for operating lease liabilities		$ 2,978
Weighted-average remaining lease term – operating leases	1 year 9 months 18 days	2 years 3 months 18 days
Weighted-average discount rate – operating leases	7.00%	7.00%

Operating Leases - Summary Of Components Of Lease Cost (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Operating leases
Operating lease cost	$ 216	$ 216	$ 432	$ 432
Variable lease cost	92	40	165	104
Total rent expense	$ 308	$ 256	$ 597	$ 536

Operating Leases - Summary Of Future Minimum Payments Under The Non-Cancelable Operating Leases (Detail) $ in Thousands	Jun. 30, 2020 USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Six months ending December 31, 2020	$ 507
Year ending December 31, 2021	1,044
Year ending December 31, 2022	1,074
Year ending December 31, 2023	51
Year ending December 31, 2024	51
Total	2,727
Less: present value discount	(251)
Operating lease liabilities	$ 2,476

Warrants - Additional Information (Detail) - $ / shares	6 Months Ended
Warrants - Additional Information (Detail) - $ / shares	Jun. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Weighted average remaining contractual life of warrants	7 years 10 months 24 days
Warrants Issued in with Two Thousand and Nineteen Credit Agreement [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights		419,992
Excercise price of each warrant	$ 16.67	$ 16.667
Warrants Issued in Two Thousand and Eighteen with Convertible Notes [Member] \| Common Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights			501,946
Excercise price of each warrant	0.10		$ 0.10
Term of warrants			10 years
Warrants Issued in Two Thousand and Eighteen Term Loan [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Class of warrants number of securities called by the warrants or rights			26,998
Excercise price of each warrant	$ 16.67		$ 16.667

Warrants - Schedule of Outstanding Warrants to Purchase the Company's Common Stock (Detail) - $ / shares	6 Months Ended
	Jun. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Class of Warrant or Right [Line Items]
Class of Warrant or Right, Outstanding	956,552	956,552
Warrants Issued in Two Thousand and Fifteen [Member] \| Common Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Common Stock
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 5.25
Warrants and Rights Outstanding, Maturity Date	Jan. 30, 2025
Class of Warrant or Right, Outstanding	7,616	7,616
Warrants Issued in Two Thousand and Eighteen with Convertible Notes [Member] \| Common Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Common Stock
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 0.10		$ 0.10
Warrants and Rights Outstanding, Maturity Date	Jun. 07, 2028
Class of Warrant or Right, Outstanding	501,946	501,946
Warrants Issued in Two Thousand and Eighteen Term Loan [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Series D convertible preferred
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 16.67		$ 16.667
Warrants and Rights Outstanding, Maturity Date	Jul. 31, 2028
Class of Warrant or Right, Outstanding	26,998	26,998
Warrants Issued in with Two Thousand and Nineteen Credit Agreement [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Class of Warrant or Right [Line Items]
Warrant or Right, Reason for Issuance, Description	Series D convertible preferred
Class of Warrant or Right, Exercise Price of Warrants or Rights	$ 16.67	$ 16.667
Warrants and Rights Outstanding, Maturity Date	May 20, 2029
Class of Warrant or Right, Outstanding	419,992	419,992

Convertible Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	6 Months Ended	12 Months Ended
	Feb. 29, 2020	Jun. 30, 2020	Dec. 31, 2019
Firm Underwritten Commitment [Member] \| Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member]
Temporary Equity [Line Items]
Stock issue share price per unit		$ 50.00
Firm Underwritten Commitment [Member] \| Minimum [Member] \| Prospective Event Trgerring Conversion of Temporary Equity into Permanent Equity [Member]
Temporary Equity [Line Items]
Sale of stock consideration received		$ 50.0
Redeemable Convertible Series A Preferred Stock [Member] \| Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		$ 0.68	$ 0.68
Redeemable Convertible Series B Preferred Stock [Member] \| Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		1.07	1.07
Redeemable Convertible Series C Preferred Stock [Member] \| Non Cumulative Dividends [Member]
Temporary Equity [Line Items]
Temporary equity dividend per share declared		$ 1.36	$ 1.36
Rhythm xcience acquisition [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares	119,993
Business combination contingent consideration shares issued value	$ 2.2
Biotonik Asset Acquisition [Member] \| Redeemable Convertible Series D Preferred Stock [Member]
Temporary Equity [Line Items]
Business combination contingent consideration shares issued shares	273,070
Business combination contingent consideration shares issued value	$ 5.0

Convertible Preferred Stock - Schedule of Initial Conversion Price Per Share for each Series of Convertible Preferred Stock (Detail)	Jun. 30, 2020 $ / shares
Redeemable Convertible Series A Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	$ 8.295
Redeemable Convertible Series B Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	13.370
Redeemable Convertible Series C Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	16.667
Redeemable Convertible Series D Preferred Stock [Member]
Disclosure of Conversion Price of Temporary Equity into Permanent Equity [Line Items]
Temporary Equity Initial Conversion Price Per Share	$ 16.667

Stockholders' Deficit - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019	Aug. 10, 2020
Class of Stock [Line Items]
Common stock shares authorised	260,000,000		260,000,000		260,000,000
Common stock par or stated value per share	$ 0.001		$ 0.001		$ 0.001
Common stock voting rights					one voting right
Proceeds from the exercise of stock options			$ 205	$ 57
Common Stock [Member]
Class of Stock [Line Items]
Stock options shares excercised during the period	64,562	8,469	64,562	8,469
Subsequent Event [Member]
Class of Stock [Line Items]
Common stock shares authorised						260,000,000
Temporary equity shares authorised						5,000,000
Amended and Restated Certificate of Incorporation [Member]
Class of Stock [Line Items]
Common stock shares authorised					220,000,000
Common stock par or stated value per share					$ 0.001

Stock-Based Compensation - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement weighted average fair value per share of stock options granted				$ 14.81
Unrecognised compensation realting to stock options not vested		$ 13,800,000		$ 13,800,000
Share based compensation non vested award period of recognition				2 years 9 months 18 days
Share based compensation by share based payment arrangement instruments other than options granted				14,945
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value				$ 14.81
Allocated share based compensation expense		1,157,000	$ 803,000	$ 2,898,000	$ 1,362,000
Performance Based Restricted Stock Units [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based compensation by share based payment arrangement instruments other than options granted	567,509
Share based compensation by share based payment arrangement instruments other than options granted weighted average grant date fair value	$ 13.37
Allocated share based compensation expense		$ 0	$ 0	$ 0	$ 0
2011 Plan [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance		3,858,099		3,858,099
Share based payment arrangement number of shares available for issuance		390,912		390,912
Share based compensation by share based payment arrangement stock options vesting term				4 years
Share based compensation by share based payment arrangement stock options contractual term				10 years

Stock-Based Compensation - Schedule of Estimate of the Fair Value of Stock Option (Detail)	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Risk-free interest rate	0.90%
Risk-free interest rate minimum		2.00%
Risk-free interest rate maximum		2.10%
Expected term in years	7 years
Expected volatility	70.00%	80.00%
Maximum [Member]
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		10 years
Minimum [Member]
Schedule of Share Based Payment Award Stock Options Valuation Assumptions [Line Items]
Expected term in years		6 years 4 months 17 days

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - Stock Option [Member] $ / shares in Units, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2020 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options outstanding as of December 31, 2019 \| shares	2,041,205
Options granted \| shares	867,031
Option exercised \| shares	(111,936)
Options forfeited \| shares	(200,213)
Stock options outstanding as of June 30, 2020 \| shares	2,596,087	2,041,205
Options vested and exercisable as of June 30, 2020 (unaudted) \| shares	1,138,429
Weighted average exercise price outstanding as of December 31, 2019 \| $ / shares	$ 9.52
Options granted \| $ / shares	14.81
Option exercised \| $ / shares	7.73
Options forfeited \| $ / shares	12.01
Weighted average exercise price outstanding as of June 30, 2020 \| $ / shares	11.17	$ 9.52
Weighted average exercise price of options vested and exercisable as of June 30, 2020 (unaudted) \| $ / shares	$ 8.34
Weighted average remaining contractual life outstanding as of December 31, 2019	7 years 9 months 18 days	7 years 8 months 12 days
Weighted average remaining contractual life outstanding as of June 30, 2020	7 years 9 months 18 days	7 years 8 months 12 days
Weighted average remaining contractual life of options vested and exercisable as of June 30, 2020 (unaudted)	6 years 1 month 6 days
Aggregate intrinsic value outstanding as of December 31, 2019 \| $	$ 7,857
Aggregate intrinsic value outstanding as of June 30, 2020 \| $	17,816	$ 7,857
Aggregate intrinsic value options vested and exercisable as of June 30, 2020 (unaudted) \| $	$ 11,037

Stock-Based Compensation - Schedule of RSA Activity (Detail)	6 Months Ended
	Jun. 30, 2020 $ / shares shares
Share-based Payment Arrangement [Abstract]
Granted of shares \| shares	14,945
Vested of shares \| shares	(14,945)
Granted of weighted average grant price \| $ / shares	$ 14.81
Vested of weighted average grant price \| $ / shares	$ 14.81

Stock-Based Compensation - Summary of the Total Stock-Based Compensation Expense for the Stock Options and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 1,157	$ 803	$ 2,898	$ 1,362
Cost of Sales [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	58	54	166	106
Research and Development Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	167	150	378	292
Selling, General and Administrative Expenses [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 932	$ 599	$ 2,354	$ 964

Net Loss Per Common Share - Summary of Calculation of the Diluted Net Loss per Common Share (Detail) - shares	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	20,125,574	17,106,180
Conversion of Series A Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	391,210	391,210
Conversion of Series B Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	3,088,444	3,088,444
Conversion of Series C Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	4,499,921	4,499,921
Conversion of Series D Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	8,593,360	6,418,437
Exercise of Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	2,596,087	1,751,616
Exercise of Common Stock Warrants [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	509,562	509,562
Exercise of Preferred Stock Warrants [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable	446,990	446,990

401(k) Retirement Plan - Additional Information (Detail) - USD ($)	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Four Zero One K Retirement Plan [Member]
Employer contribution to defined benefit plan	$ 0	$ 0

Related Party Transactions - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Director and Shareholder [Member] \| Patent Rights from Director and Shareholder [Member]
Related Party Transaction [Line Items]
Royalty expense	$ 16,000	$ 11,000	$ 37,000	$ 23,000
Director and Shareholder [Member] \| Patent Rights from Director and Shareholder [Member] \| Royalty Expenses [Member]
Related Party Transaction [Line Items]
Royalty expense as a percentage of net sales			3.00%
Beneficial Customer [Member] \| Sales [Member]
Related Party Transaction [Line Items]
Revenue from related parties	200,000		$ 500,000	100,000
Director and the Chairman [Member] \| Consulting Agreement [Member] \| Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party	47,000,000	74,000,000	100,000	200,000
Officer [Member] \| Consulting Agreement [Member] \| Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party		94,000,000	200
Current Director and Officer [Member] \| Consulting Agreement [Member] \| Selling, General and Administrative Expenses [Member]
Related Party Transaction [Line Items]
Consulting fees incurred for related party		100,000		200,000
Orbimed Royalty Oppurtunities Two LP and Deerfield Private Design Fund LP [Member] \| 2019 Credit Agreement [Member]
Related Party Transaction [Line Items]
Line of credit maximum borrowing capacity					$ 70,000,000.0
Line of credit cumulative drawdowns till date	40,000,000.0		40,000,000.0
Interest expenses related party	$ 1,300,000	$ 600,000	$ 2,700,000	$ 600,000

Subsequent Events - Additional Information (Detail) - $ / shares			6 Months Ended
	Aug. 10, 2020	Jul. 28, 2020	Jun. 30, 2020	Dec. 31, 2019
Subsequent Event [Line Items]
Common stock shares outstanding			775,403	695,902
Share based compensation by share based payment arrangement options equity instruments other than options in period			14,945
Series D Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares			273,070
Subsequent Event [Member]
Subsequent Event [Line Items]
Common stock shares outstanding	26,719,993
Reverse stock split		common stock and convertible preferred stock on a 9.724-for-one basis
Subsequent Event [Member] \| Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Shares of common stock were reserved for issuance	2,193,360
Subsequent Event [Member] \| Common Stock [Member] \| Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options grants in period	850,217
Shares of common stock were authorized	387,063
Subsequent Event [Member] \| Restricted Stock Units (RSUs) [Member] \| Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options equity instruments other than options in period	211,251
Subsequent Event [Member] \| Restricted Stock Awards [Member] \| Two Thousand And Twenty Plan [Member]
Subsequent Event [Line Items]
Share based compensation by share based payment arrangement options equity instruments other than options in period	17,976
Subsequent Event [Member] \| Series A Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	391,210
Subsequent Event [Member] \| Series B Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	3,088,444
Subsequent Event [Member] \| Series C Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	4,499,921
Subsequent Event [Member] \| Series D Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Coversion of shares as result of conversion of temporary equity into permanent equity	8,593,360
Class of warrants number of securities called by the warrants or rights	446,990
Excercise price of each warrant	$ 16.67
Subsequent Event [Member] \| Convertible Preferred Stock [Member]
Subsequent Event [Line Items]
Reverse stock split		9.724-for-one basis
Subsequent Event [Member] \| IPO [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares	10,147,058
Subsequent Event [Member] \| Over-Allotment Option [Member]
Subsequent Event [Line Items]
Shares issued during the period,shares	1,323,529
Subsequent Event [Member] \| IPO And Over Allotment [Member]
Subsequent Event [Line Items]
Stock issue share price per unit	$ 18.00